Publications (14) View all
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Article: Pulmonary diffusion capacity as prognostic marker in chronic heart failure.
European Heart Journal 04/2002; 23(6):429-31. · 10.48 Impact Factor -
Article: Skeletal muscle characteristics, muscle strength and thigh muscle area in patients before and after cardiac transplantation.
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ABSTRACT: Patients with chronic heart failure demonstrate several skeletal muscle abnormalities. The underlying mechanisms are unclear. After cardiac transplantation, cardiac function is restored, but exercise capacity is still impaired. To evaluate the influence of cardiac transplantation on skeletal muscle fibre composition, fibre area and capillarization as well as muscle enzymes, lactate, thigh muscle area and strength. Ten patients were longitudinally investigated before, 1-3 and 6-9 months after transplantation. Ten healthy individuals served as controls. A biopsy from the lateral vastus muscle was obtained and the thigh muscle area was measured with computed tomography. Muscle strength in the knee extensors and exercise capacity were also evaluated. Muscle lactate was elevated in patients vs. controls (3.6+/-3.0 vs. 1.5+/-0.7 mmol/kg wet wt., P=0.037), and decreased to normal (1.4+/-0.3 mmol/kg wet wt., P=0.038) after transplantation. Citrate synthase activity was decreased in patients (5.6+/-1.5 micromol/g wet wt./min) vs. controls (8.1+/-1.6 micromol/g wet wt./min, P=0.0018), and did not change post transplantation. Patients had decreased number of capillaries in contact with each fibre vs. controls (2.6+/-0.5 vs. 3.5+/-1.0, P=0.039) which persisted post transplantation. Exercise capacity increased after transplantation (74+/-22 vs. 118+/-26 W, P=0.0002), whereas muscle strength did not improve significantly. The persisting intrinsic abnormalities in skeletal muscle after cardiac transplantation may contribute to the impaired exercise capacity observed in cardiac transplant recipients.European Journal of Heart Failure 02/2001; 3(1):59-67. · 4.90 Impact Factor -
Article: Angiotensin-converting enzyme gene expression in skeletal muscle in patients with chronic heart failure.
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ABSTRACT: Skeletal muscle factors may influence functional limitation in patients with heart failure. The renin-angiotensin system is activated in chronic heart failure. Treatment with angiotensin-converting enzyme (ACE) inhibitors improve symptoms and prognosis. The goal of this study was to quantify and localize skeletal muscle ACE-mRNA in patients with chronic heart failure and in control subjects, and to elucidate skeletal muscle fiber area and capillary density. Biopsies from the lateral vastus muscle were taken from 9 patients before and after treatment with enalapril and in 10 control subjects. ACE-mRNA was quantified with reverse transcription polymerase chain reaction. Immunohistochemistry was used to localize ACE within skeletal muscle. No difference in ACE-mRNA transcripts between patients and control subjects was detected, nor did ACE gene expression change after treatment with enalapril. The number of ACE-mRNA transcripts was related to muscle fiber area, whereas an inverse relationship between the number of ACE transcripts and capillary density was found. ACE was detected in the endothelial cells of capillaries in skeletal muscle. ACE is expressed in skeletal muscle and is confined to endothelial cells. The close relationship between capillary density and number of ACE transcripts indicate that activation of the renin-angiotensin system has an impact on capillary growth.Journal of Cardiac Failure 10/1998; 4(3):185-91. · 3.66 Impact Factor -
Article: Is 6-minute walk test of value in congestive heart failure?
American Heart Journal 10/1998; 136(3):371-2. · 4.65 Impact Factor -
Article: Muscular performance in heart failure.
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ABSTRACT: Some of the major symptoms in patients with chronic heart failure are muscle weakness and fatigue. However, not much is known about muscle performance in these patients compared to healthy controls. Activity level, gait speed, hand grip strength, muscle performance of the knee extensors and flexors along with the plantar and dorsal flexors of the foot were evaluated. Muscle biopsies from the lateral vastus lateralis were taken. Sixteen patients in New York Heart Association class II or III were tested and compared to 112 reference subjects. Compared to the reference subjects, there was a reduction in activity level, gait speed, isometric and isokinetic peak torque for knee extension at different velocities, hand grip strength, peak torque for plantar and dorsal flexion of the ankle and isometric and isokinetic endurance for the knee extension. Recovery was faster. There were small differences in fiber composition. 3-Hydroxy-acylCoA-dehydrogenase and citrate synthase were lower, and lactate dehydrogenase was increased. Muscle performance is affected in terms of both strength and endurance, which might affect performance in everyday activities. The more pronounced reduction in hand grip compared to the other muscles tested could be an indication of intrinsic abnormalities in the skeletal muscle.Journal of Cardiac Failure 07/1998; 4(2):97-104. · 3.66 Impact Factor
