Skeletal muscle mass and exercise performance in stable ambulatory patients with heart failure

The purpose of this study was to determine whether skeletal muscle atrophy limits the maximal exercise capacity of stable ambulatory patients with heart failure. Body composition and maximal exercise capacity were measured in 100 stable ambulatory patients with heart failure. Body composition was assessed by using dual-energy X-ray absorption. Peak exercise oxygen consumption (Vo(2peak)) and the anaerobic threshold were measured by using a Naughton treadmill protocol and a Medical Graphics CardioO(2) System. Vo(2peak) averaged 13.4 +/- 3.3 ml . min(-1). kg(-1) or 43 +/- 12% of normal. Lean body mass averaged 52.9 +/- 10.5 kg and leg lean mass 16.5 +/- 3.6 kg. Leg lean mass correlated linearly with Vo(2peak) (r= 0.68, P < 0.01), suggesting that exercise performance is influenced by skeletal muscle mass. However, lean body mass was comparable to levels noted in 1,584 normal control subjects, suggesting no decrease in muscle mass. Leg muscle mass was comparable to levels noted in 34 normal control subjects, further supporting this conclusion. These findings suggest that exercise intolerance in stable ambulatory patients with heart failure is not due to skeletal muscle atrophy.