Functional and morphological skeletal muscle abnormalities correlate with reduced electromyographic activity in chronic heart failure

Background Exercise intolerance and early muscle fatigue are key symptoms in patients with chronic heart failure (CHF). In advanced stages of the disease, profound metabolic abnormalities have been described finally leading to a catabolic state with progressive loss of muscle bulk. The aim of this study was to investigate morphological, functional and electromyographical parameters of the skeletal muscle in CHF. Methods We included 17 patients with CHF and 12 age-matched healthy controls (left ventricular ejection fraction 25 ± 2 versus 68 ± 1%, body mass index 26.6 ± 0.8 versus 28.0 ± 1.0 kg/m2; P=NS) in this study. Cross-sectional area (CSA) of the thigh was assessed by computed tomography. Under electromyographical control, maximal and submaximal (30%) isometric strength as well as the relative decrease of muscle strength of the quadriceps muscle over a period of 20 s were determined. Results Patients with CHF showed a significant reduction of muscle CSA (134.8 ± 5.3 versus 165.2 ± 7.4 cm2, P=0.002) as compared with healthy controls. The maximal quadriceps muscle strength was found to be significantly reduced in patients with CHF (226.7 ± 22.3 versus 286.9 ± 17.1 N, P