Comparisons of the Skeletal Muscle Metabolic Abnormalities in the Arm and Leg Muscles of Patients With Chronic Heart Failure
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概要
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Background It has been suspected for some time that patients with chronic heart failure (CHF) have abnormal muscle metabolism, so in the present study the muscle metabolism of the arm and leg were compared by ^<31>P magnetic resonance spectroscopy (^<31>P-MRS) to examine the relationship to exercise tolerance. Methods and Results The study group comprised 13 patients and 11 normal controls. Calf-plantar and forearm-wrist flexion were performed to evaluate the metabolic capacity assessed as the phosphocreatine break-down rate (PCr-slope) and muscle pH at a submaximal (70% peak) work rate (submax-pH). Exercise of both the arm and leg resulted in an earlier decrease in PCr and muscle pH in patients with CHF compared with controls. There were significant correlations between peak oxygen uptake (peak V^^・_<02>) and the PCr-slope in both limbs in patients with CHF (forearm: r=0.63, p<0.05; calf: r=0.60, p<0.05), but no correlations in normal controls. There was a close correlation between the ventilatory anaerobic threshold (AT) and the PCr-slope in the calf (r=0.85, p<0.01), but not in the forearm in patients with CHF. Submax-pH in both upper and lower limbs was not significantly correlated to peak V^^・_<02> or AT in either patients with CHF or controls. Conclusions Although metabolic abnormalities during exercise are seen in both arms and legs, leg muscle abnormalities, in particular, are closely related to systemic exercise intolerance in patients with CHF.
- 社団法人日本循環器学会の論文
- 2004-05-20
著者
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Yamada Yutaka
Department of Internal Medicine, Asahikawa City Hospital
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Kitabatake Akira
Department of Cardiovascular Medicine, Graduate School of Medicine, Hokkaido University
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Ohtsubo Mitsunori
Department of Cardiovascular Medicine, Kushiro Rousai Hospital
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Murakami Takeshi
Department of Physics, Tokyo Institute of Technology
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Nagai Tatsuya
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Okita Koichi
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Yonezawa Kazuya
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Hanada Akiko
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Morita Noriteru
Department of Laboratory Medicine, Hokkaido University Graduate School of Medicine
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Nishijima Hirotaka
Sapporo Health Promotion Center
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Murakami Takeshi
Sapporo Health Promotion Center
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Okita Koichi
Dept. Wellness Planning Ebetsu
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Nagai Tatsuya
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Hanada Akiko
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Morita Noriteru
Dept. Wellness Planning Ebetsu
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Morita Noriteru
Department Of Health And Sports Science Hokkaido University Of Education Iwamizawa Campus
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Yonezawa Kazuya
Department Of Cardiology School Of Medicine Hokkaido University
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Kitabatake Akira
Department Of Cardicvascular Medicine Hokkaidou University
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Ohtsubo Mitsunori
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Okita Koichi
Department Of Applied Chemistry Faculty Of Engineering Kyushu Institute Of Technology
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Murakami Takeshi
Department Of Accelerator And Medical Physics National Institute Of Radiological Sciences
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Nagai Tatsuya
Department Of Applied Physics Faculty Of Engineering Tohoku University
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Yamada Yutaka
Department Of Cardiology Shiga University Of Medical Science
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Yamada Yutaka
Department Of Animal Production Hokkaido National Agricultural Experiment Station
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Yamada Yutaka
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Kitabatake Akira
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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YAMADA Yutaka
Department of Aeronautics and Astronautics, Faculty of Engineering, Kyushu University
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