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Heart Failure Reviews

, Volume 13, Issue 1, pp 21–37 | Cite as

Implications of chronic heart failure on peripheral vasculature and skeletal muscle before and after exercise training

  • Brian D. Duscha
  • P. Christian Schulze
  • Jennifer L. Robbins
  • Daniel E. FormanEmail author
Article

Abstract

 The pathophysiology of chronic heart failure (CHF) is typically conceptualized in terms of cardiac dysfunction. However, alterations in peripheral blood flow and intrinsic skeletal muscle properties are also now recognized as mechanisms for exercise intolerance that can be modified by therapeutic exercise. This overview focuses on blood delivery, oxygen extraction and utilization that result from heart failure. Related features of inflammation, changes in skeletal muscle signaling pathways, and vulnerability to skeletal muscle atrophy are discussed. Specific focus is given to the ways in which perfusion and skeletal muscle properties affect exercise intolerance and how peripheral improvements following exercise training increase aerobic capacity. We also identify gaps in the literature that may constitute priorities for further investigation.

Keywords

Vascular Skeletal muscle Capillary density Muscle fiber Mitochondria Inflammation Apoptosis Ubiquitin ligase Exercise training 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Brian D. Duscha
    • 1
  • P. Christian Schulze
    • 2
  • Jennifer L. Robbins
    • 1
  • Daniel E. Forman
    • 3
    • 4
    • 5
    Email author
  1. 1.Duke University Medical CenterDurhamUSA
  2. 2.Division of CardiologyNew York Presbyterian Hospital, Columbia University Medical CenterNew YorkUSA
  3. 3.Brigham and Women’s HospitalBostonUSA
  4. 4.Veteran’s Administration Medical Center (VAMC) of BostonBostonUSA
  5. 5.Harvard Medical SchoolBostonUSA

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