Sarcopenic Obesity and the Pathogenesis of Exercise Intolerance in Heart Failure with Preserved Ejection Fraction

被引:57
作者
Upadhya B. [1 ]
Haykowsky M.J. [2 ]
Eggebeen J. [1 ]
Kitzman D.W. [1 ,3 ]
机构
[1] Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, 27157-1045, NC
[2] Faculty of Rehabilitation Medicine, Alberta Cardiovascular and Stroke Research Centre (ABACUS), Mazankowski Alberta Heart Institute, University of Alberta, 3-16 Corbett Hall, Edmonton, T6G 2G4, AB
[3] Cardiology and Geriatrics, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, 27157-1045, NC
基金
美国国家卫生研究院;
关键词
Aging; Exercise intolerance; Exercise training; Heart failure with preserved ejection fraction; Obesity; Peak oxygen consumption; Sarcopenia; Skeletal muscle;
D O I
10.1007/s11897-015-0257-5
中图分类号
学科分类号
摘要
Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure (HF) in older adults. The primary chronic symptom in patients with HFpEF, even when well compensated, is severe exercise intolerance. Cardiac and peripheral functions contribute equally to exercise intolerance in HFpEF, though the latter has been the focus of fewer studies. Of note, multiple studies with exercise training have shown that exercise intolerance can improve significantly in the absence of improvements in exercise cardiac output, indicating a role of peripheral, noncardiac adaptations. In addition, clinical drug trials performed to date in HFpEF, all of which have focused on influencing cardiovascular function, have not been positive on primary clinical outcomes and most have not improved exercise capacity. Mounting evidence indicates that sarcopenic obesity, characterized by the coexistence of excess fat mass and decreased muscle mass, could contribute to the pathophysiology of exercise intolerance in older HFpEF patients and may provide avenues for novel treatments. © 2015, Springer Science+Business Media New York.
引用
收藏
页码:205 / 214
页数:9
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