Dissociation between muscle metabolism and oxygen kinetics during recovery from exercise in patients with chronic heart failure

doi:10.1136/heart.83.2.161

Heart 2000;83:161-166; doi:10.1136/heart.83.2.161

Heart 2000;83:161-166 ( February )

Cardiovascular medicine

Dissociation between muscle metabolism and oxygen kinetics during recovery from exercise in patients with chronic heart failure A Hanada^a, K Okita^a, K Yonezawa^a, M Ohtsubo^a, T Kohya^a, T Murakami^a, H Nishijima^b, M Tamura^c, A Kitabatake^a

^a Department of Cardiovascular Medicine, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kitaku, Sapporo 060-8638, Japan, ^b Sapporo Health Promotion Centre, Sapporo, Japan, ^c Biophysics Group, Research Institute for Electronic Science, Hokkaido University, Sapporo, Japan

Correspondence to: Dr Hanada email: cvext{at}med.hokudai.ac.jp

Accepted 17 August 1999

OBJECTIVE $---$ To estimate muscle metabolism and oxygen delivery to skeletal muscle in patients with chronic heartfailure.
METHODS $---$ 13 patients with chronic heart failure and 15 controls performed calf plantar flexion for six minutes at a constant workloadof 50% of one repetition maximum. During recovery from exercise,skeletal muscle content of oxygenated haemoglobin (oxy-Hb) andthe level of phosphocreatine (PCr) were measured by near-infraredspectroscopy and ³¹P-magnetic resonance spectroscopy,respectively.
RESULTS $---$ The mean (SD) time constants of PCr and oxy-Hb during recovery from exercise were significantly greater in patients with chronicheart failure than in normal subjects ( $tau$ PCr: 76.3 (30.2) s v36.5 (5.8) s; $tau$ oxy-Hb: 48.3 (7.3) s v 30.1 (7.7) s; p < 0.01).Both time constants were similar in normal subjects, while the $tau$ PCr was significantly greater than the $tau$ oxy-Hb in patientswith chronic heart failure.
CONCLUSIONS $---$ The slower recovery of PCr compared with oxy-Hb in patients with chronic heart failure indicates that haemoglobin resaturationis not a major rate limiting factor of PCr resynthesis. It issuggested that muscle metabolic recovery may depend more on oxygenutilisation than on haemoglobin resaturation or oxygen deliveryin patients with chronic heartfailure.

Keywords: near-infrared spectroscopy; ³¹P-magnetic resonance spectroscopy; chronic heart failure; exercise tolerance

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