Panizzolo Fausto A, Maiorana Andrew J, Naylor Louise H, Lichtwark Glen A, Dembo Lawrence, Lloyd David G, Green Daniel J, Rubenson Jonas
1School of Sport Science, Exercise and Health, University of Western Australia, Crawley, Western Australia, AUSTRALIA; 2Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, AUSTRALIA; 3School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, AUSTRALIA; 4School of Human Movement Studies, University of Queensland, St. Lucia Campus, Queensland, AUSTRALIA; 5Envision Medical Imaging, Perth, Western Australia, AUSTRALIA; 6Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast, Queensland, AUSTRALIA; and 7Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM.
Med Sci Sports Exerc. 2015 Mar;47(3):498-508. doi: 10.1249/MSS.0000000000000431.
Skeletal muscle wasting is well documented in chronic heart failure (CHF). This article provides a more detailed understanding of the morphology behind this muscle wasting and the relation between muscle morphology, strength, and exercise capacity in CHF. We investigated the effect of CHF on lower limb lean mass, detailed muscle-tendon architecture of the individual triceps surae muscles (soleus (SOL), medial gastrocnemius, and lateral gastrocnemius) and how these parameters relate to exercise capacity and strength.
Eleven patients with CHF and 15 age-matched controls were recruited. Lower limb lean mass was assessed by dual energy x-ray absorptiometry and the architecture of skeletal muscle and tendon properties by ultrasound. Plantarflexor strength was assessed by dynamometry.
Patients with CHF exhibited approximately 25% lower combined triceps surae volume and physiological cross-sectional area (PCSA) compared with those of control subjects (P < 0.05), driven in large part by reductions in the SOL. Only the SOL volume and the SOL and medial gastrocnemius physiological cross-sectional area were statistically different between groups after normalizing to lean body mass and body surface area, respectively. Total lower limb lean mass did not differ between CHF and control subjects, further highlighting the SOL specificity of muscle wasting in CHF. Moreover, the volume of the SOL and plantarflexor strength correlated strongly with peak oxygen uptake (V˙O2peak) in patients with CHF.
These findings suggest that the SOL may be a sentinel skeletal muscle in CHF and provide a rationale for including plantarflexor muscle training in CHF care.
骨骼肌萎缩在慢性心力衰竭（CHF）中已有充分记载。本文旨在更详细地了解这种肌肉萎缩背后的形态学特征，以及CHF中肌肉形态、力量和运动能力之间的关系。我们研究了CHF对下肢瘦体重、腓肠肌三头肌（比目鱼肌、内侧腓肠肌和外侧腓肠肌）的详细肌肉肌腱结构的影响，以及这些参数与运动能力和力量的关系。
招募了11名CHF患者和15名年龄匹配的对照组。通过双能X线吸收法评估下肢瘦体重，通过超声评估骨骼肌结构和肌腱特性。通过测力计评估跖屈力量。
与对照组相比，CHF患者的腓肠肌三头肌总体积和生理横截面积（PCSA）降低了约25%（P < 0.05），这在很大程度上是由比目鱼肌的减少所致。分别将两组数据按瘦体重和体表面积进行归一化处理后，只有比目鱼肌体积以及比目鱼肌和内侧腓肠肌的生理横截面积在两组之间存在统计学差异。CHF患者和对照组之间的下肢总瘦体重没有差异，这进一步突出了CHF中肌肉萎缩对比目鱼肌的特异性。此外，CHF患者的比目鱼肌体积和跖屈力量与峰值摄氧量（V˙O2peak）密切相关。
这些发现表明，比目鱼肌可能是CHF中的哨兵骨骼肌，并为在CHF护理中纳入跖屈肌训练提供了理论依据。
