Exercise intolerance in chronic heart failure: The role of cortisol and the catabolic state

被引：25

作者：

Tzanis G. ^{[1
]}

Dimopoulos S. ^{[1
]}

Agapitou V. ^{[1
]}

Nanas S. ^{[1
]}

机构：

[1] 1st Critical Care Medicine Department, Evgenidio Hospital, National and Kapodestrian University of Athens, Athens 11528, Papadiamantopoulou str.

来源：

Current Heart Failure Reports | 2014年 / 11卷 / 1期

关键词：

Cachexia; Catabolism; Chronic heart failure; Cortisol; Exercise intolerance; Hormones; Myopathy; Skeletal muscle;

D O I：

10.1007/s11897-013-0177-1

中图分类号：

学科分类号：

摘要：

Chronic heart failure (CHF) is a complex clinical syndrome leading to exercise intolerance due to muscular fatigue and dyspnea. Hemodynamics fail to explain the reduced exercise capacity, while a significant skeletal muscular pathology seems to constitute the main underlying mechanism for exercise intolerance in CHF patients. There have been proposed several metabolic, neurohormonal and immune system abnormalities leading to an anabolic/catabolic imbalance that plays a central role in the pathogenesis of the wasting process of skeletal muscle myopathy. The impairment of the anabolic axes is associated with the severity of symptoms and the poor outcome in CHF, whereas increased cortisol levels are predictive of exercise intolerance, ventilatory inefficiency and chronotropic incompetence, suggesting a significant contributing mechanism to the limited functional status. Exercise training and device therapy could have beneficial effects in preventing and treating muscle wasting in CHF. However, specific anabolic treatment needs more investigation to prove possible beneficial effects. © 2013 Springer Science+Business Media New York.

引用

页码：70 / 79

页数：9

共 93 条

[1]

Anker S.D., Ponikowski P., Varney S., Chua T.P., Clark A.L., Webb-Peploe K.M., Harrington D., Kox W.J., Poole-Wilson P.A., Coats A.J.S., Wasting as independent risk factor for mortality in chronic heart failure, Lancet, 349, 9058, pp. 1050-1053, (1997)

[2]

Katz A.M., Katz P.B., Diseases of the heart in the works of Hippocrates, Br Heart J., 24, pp. 257-264, (1962)

[3]

Mosterd A., Hoes A.W., Clinical epidemiology of heart failure, Heart, 93, 9, pp. 1137-1146, (2007)

[4]

Go A.S., Mozaffarian D., Roger V.L., Benjamin E.J., Berry J.D., Borden W.B., Et al., Heart disease and stroke statistics-2013 update: A report from the American Heart Association, Circulation, 127, 1, (2013)

[5]

Franciosa J.A., Baker B.J., Seth L., Pulmonary versus systemic hemodynamics in determining exercise capacity of patients with chronic left ventricular failure, American Heart Journal, 110, 4, pp. 807-813, (1985)

[6]

Wilson J.R., Martin J.L., Ferraro N., Impaired skeletal muscle nutritive flow during exercise in patients with congestive heart failure: Role of cardiac pump dysfunction as determined by the effect of dobutamine, American Journal of Cardiology, 53, 9, pp. 1308-1315, (1984)

[7]

Wilson J.R., Mancini D.M., Dunkman W.B., Exertional fatigue due to skeletal muscle dysfunction in patients with heart failure, Circulation, 87, 2, pp. 470-475, (1993)

[8]

Massie B., Conway M., Yonge R., Frostick S., Ledingham J., Sleight P., Radda G., Rajagopalan B., Skeletal muscle metabolism in patients with congestive heart failure: Relation to clinical severity and blood flow, Circulation, 76, 5, pp. 1009-1019, (1987)

[9]

Drexler H., Riede U., Munzel T., Konig H., Funke E., Just H., Alterations of skeletal muscle in chronic heart failure, Circulation, 85, 5, pp. 1751-1759, (1992)

[10]

Coats A.J., Clark A.L., Piepoli M., Volterrani M., Poole-Wilson P.A., Symptoms and quality of life in heart failure: The muscle hypothesis, Br Heart J, 72, 2 SUPPL., pp. 36-39, (1994)

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