Heart Failure Reviews

, Volume 17, Issue 3, pp 421–436 | Cite as

Intrinsic skeletal muscle alterations in chronic heart failure patients: a disease-specific myopathy or a result of deconditioning?

  • T. A. RehnEmail author
  • M. Munkvik
  • P. K. Lunde
  • I. Sjaastad
  • O. M. Sejersted


Chronic heart failure (CHF) patients frequently experience impaired exercise tolerance due to skeletal muscle fatigue. Studies suggest that this in part is due to intrinsic alterations in skeletal muscle of CHF patients, often interpreted as a disease-specific myopathy. Knowledge about the mechanisms underlying these skeletal muscle alterations is of importance for the pathophysiological understanding of CHF, therapeutic approach and rehabilitation strategies. We here critically review the evidence for skeletal muscle alterations in CHF, the underlying mechanisms of such alterations and how skeletal muscle responds to training in this patient group. Skeletal muscle characteristics in CHF patients are very similar to what is reported in response to chronic obstructive pulmonary disease (COPD), detraining and deconditioning. Furthermore, skeletal muscle alterations observed in CHF patients are reversible by training, and skeletal muscle of CHF patients seems to be at least as trainable as that of matched controls. We argue that deconditioning is a major contributor to the skeletal muscle dysfunction in CHF patients and that further research is needed to determine whether, and to what extent, the intrinsic skeletal muscle alterations in CHF represent an integral part of the pathophysiology in this disease.


Congestive heart failure Deconditioning Skeletal muscle Inflammation Exercise Training 


Conflict of interest

Drs Rehn, Munkvik, Lunde, Sjaastad and Sejersted have no conflicts of interests or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • T. A. Rehn
    • 1
    • 2
    Email author
  • M. Munkvik
    • 1
    • 2
  • P. K. Lunde
    • 1
    • 2
  • I. Sjaastad
    • 1
    • 2
    • 3
  • O. M. Sejersted
    • 1
    • 2
  1. 1.Institute for Experimental Medical ResearchOslo University HospitalOsloNorway
  2. 2.Center for Heart Failure Research, University of OsloOsloNorway
  3. 3.Department of CardiologyOslo University HospitalOsloNorway

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