Determinants of exercise intolerance in patients with heart failure and reduced or preserved ejection fraction

作者：Haykowsky Mark J^*; Tomczak Corey R; Scott Jessica M; Paterson D Ian; Kitzman Dalane W

来源：Journal of Applied Physiology, 2015, 119(6): 739-744.

DOI：10.1152/japplphysiol.00049.2015

• exercise physiology
• heart failure and preserved ejection fraction
• heart failure and reduced ejection fraction

This mini-review summarizes the literature regarding the mechanisms of exercise intolerance in patients with heart failure and reduced or preserved ejection fraction (HFREF and HFPEF, respectively). Evidence to date suggests that the reduced peak pulmonary oxygen uptake (pulm (V) over dot(O2)) in patients with HFREF compared with healthy controls is due to both central (reduced convective O-2 transport) and peripheral factors (impaired skeletal muscle blood flow, decreased diffusive O-2 transport coupled with abnormal skeletal morphology, and metabolism). Although central and peripheral impairments also limit peak pulm (V) over dot(O2) in HFPEF patients compared with healthy controls, emerging data suggest that the latter may play a relatively greater role in limiting exercise performance in these patients. Unlike HFREF, currently there is limited evidence-based therapies that improve exercise capacity in HFPEF patients, therefore future studies are required to determine whether interventions targeted to improve peripheral vascular and skeletal muscle function result in favorable improvements in peak pulm and leg (V) over dot(O2) and their determinants in HFPEF patients.

• 出版日期2015-9-15
• 单位Saskatchewan; Saskatoon