Evaluation of energy metabolism in skeletal muscle of patients with heart failure with gated phosphorus-31 nuclear magnetic resonance.

Exertional fatigue is a major limiting symptom in patients with heart failure. To investigate the metabolic basis of this fatigue, we used gated nuclear magnetic resonance spectroscopy to compare inorganic phosphate (Pi), phosphocreatine (PCr) and pH levels, and fatigue (1 to 4+) during mild forearm exercise in eight normal men and nine men with heart failure. Wrist flexion every 5 sec for 7 min was performed at 1, 2, and 3 J (average power output = 0.2, 0.4, and 0.6 W). In both groups linear relationships were noted between power output and Pi/PCr; the slope of this relationship was used to compare PCr depletion patterns. At rest both groups had similar Pi/PCr ratios (normal subjects 0.12 +/- 0.06, those with heart failure 0.15 +/- 0.03) and pH (normal subjects 7.04 +/- 0.13, those with heart failure 7.10 +/- 0.11). In normal subjects exercise resulted in a progressive increase in Pi/PCr (slope = 1.17 +/- 0.20 Pi/PCr units/W), a reduction in pH only at 0.6 W (0.2 W: 7.03 +/- 0.10, 0.4 W: 7.01 +/- 0.10, 0.6 W: 6.88 +/- 16) and moderate fatigue (0.2 W: 0 +/- 0, 0.4 W: 1.3 +/- 0.5, 0.6 W: 1.9 +/- 0.6). In patients with heart failure exercise resulted in significantly greater fatigue at all workloads (0.2 W: 1.0 +/- 0.5, 0.4 W: 1.9 +/- 0.6, 0.6 W: 2.9 +/- 0.5).(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  B. Chance,et al.  Biochemical and 31P-NMR studies of the energy metabolism in relation to oxygen supply in rat skeletal muscle during exercise. , 1984, Advances in experimental medicine and biology.

[2]  J. Wilson,et al.  Exercise intolerance in patients with chronic left heart failure: relation to oxygen transport and ventilatory abnormalities. , 1983, The American journal of cardiology.

[3]  B. Chance,et al.  31P NMR studies of control of mitochondrial function in phosphofructokinase-deficient human skeletal muscle. , 1982, Proceedings of the National Academy of Sciences of the United States of America.

[4]  A. Fishman,et al.  Oxygen Utilization and Ventilation During Exercise in Patients with Chronic Cardiac Failure , 1982, Circulation.

[5]  J. Ingwall Phosphorus nuclear magnetic resonance spectroscopy of cardiac and skeletal muscles. , 1982, The American journal of physiology.

[6]  L. Hermansen,et al.  Effect of metabolic changes on force generation in skeletal muscle during maximal exercise. , 2008, Ciba Foundation symposium.

[7]  B Chance,et al.  Mitochondrial regulation of phosphocreatine/inorganic phosphate ratios in exercising human muscle: a gated 31P NMR study. , 1981, Proceedings of the National Academy of Sciences of the United States of America.

[8]  G K Radda,et al.  Examination of a case of suspected McArdle's syndrome by 31P nuclear magnetic resonance. , 1981, The New England journal of medicine.

[9]  H. Sjöholm,et al.  Glycolytic and oxidative energy metabolism and contraction characteristics of intact human muscle. , 1981, Ciba Foundation symposium.

[10]  D. Wilkie,et al.  Muscular fatigue investigated by phosphorus nuclear magnetic resonance , 1978, Nature.

[11]  K. Sahlin,et al.  Phosphagen and lactate contents of m. quadriceps femoris of man after exercise. , 1977, Journal of applied physiology: respiratory, environmental and exercise physiology.

[12]  J. Longhurst,et al.  Impaired Forearm Oxygen Consumption during Static Exercise in Patients with Congestive Heart Failure , 1976, Circulation.

[13]  J. Holm,et al.  Enzyme activities in skeletal muscles from patients with peripheral arterial insufficiency. , 1976, European journal of clinical investigation.

[14]  F. Booth,et al.  Biochemical adaptations to endurance exercise in muscle. , 1976, Annual review of physiology.

[15]  J. Longhurst,et al.  A Comparison of Regional Blood Flow and Oxygen Utilization During Dynamic Forearm Exercise in Normal Subjects and Patients with Congestive Heart Failure , 1974, Circulation.

[16]  R. B. Moon,et al.  Determination of intracellular pH by 31P magnetic resonance. , 1973, The Journal of biological chemistry.

[17]  P. Björntorp,et al.  Metabolic Activity in Human Skeletal Muscle Effect of Peripheral Arterial Insufficiency , 1972, European journal of clinical investigation.

[18]  B. Saltin,et al.  Lactate, ATP, and CP in working muscles during exhaustive exercise in man. , 1970, Journal of applied physiology.

[19]  B CHANCE,et al.  Respiratory enzymes in oxidative phosphorylation. III. The steady state. , 1955, The Journal of biological chemistry.

[20]  B. Chance,et al.  31 p NMR studies of control of mitochondrial function in phosphofructokinase-deficient human skeletal muscle ( metabolic control / exercising human skeletal tissues / ADP control ) , 2022 .