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Beneficial effects of chronic low-frequency stimulation of thigh muscles in patients with advanced chronic heart failure.

Abstract：

AIMS:Patients with chronic heart failure (CHF) exhibit detrimental changes in skeletal muscle that contribute to their impaired physical performance. This study investigates the possibility of counteracting these changes by chronic low-frequency electrical stimulation (CLFS) of left and right thigh muscles. METHODS AND RESULTS:(mean+/-SD) 32 CHF patients (53+/-10 years) with an LVEF of 22+/-5%, NYHA II-IV, undergoing optimized drug therapy, were randomized in a CLFS group (CLFSG) or a control group (controls). The groups differed in terms of the intensity of stimulation, which elicited strong muscle contractions only in the CLFSG, whereas the controls received current input up to the sensory threshold without muscle contractions. Functional capacity was assessed by peak VO(2), work capacity, and a 6-min-walk (6-MW). Muscle biopsies were analyzed for myosin heavy chain (MHC) isoforms, citrate synthase (CS) and glyceraldehydephosphate dehydrogenase (GAPDH) activities. Peak VO(2)(mlmin(-1)kg -1) increased from 9.6+/-3.5 to 11.6+/-2.8 (P<0.001) in the CLFSG, and decreased from 10.6+/-2.8 to 9.4+/-3.2 (P<0.05) in the controls. The increase in the CLFSG was paralleled by increases in maximal workload (P<0.05) and oxygen uptake at the anaerobic threshold (P<0.01). The corresponding values of the controls were unchanged, as also the 6-MW values, the MHC isoform distribution, and both CS and GAPDH activities. In the CLFSG, the 6-MW values increased (P<0.001), CS activity was elevated (P<0.05), GAPDH activity decreased (P<0.01), and the MHC isoforms were shifted in the slow direction with increases in MHCI at the expense of MHCIId/x (P<0.01). CONCLUSIONS:Our results suggest that CLFS is a suitable treatment to counteract detrimental changes in skeletal muscle and to increase exercise capacity in patients with severe CHF.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Nuhr MJ,Pette D,Berger R,Quittan M,Crevenna R,Huelsman M,Wiesinger GF,Moser P,Fialka-Moser V,Pacher R

doi

10.1016/j.ehj.2003.09.027

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

136-43

issue

eissn

0195-668X

issn

1522-9645

pii

S0195668X03006456

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

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Beneficial effects of chronic low-frequency stimulation of thigh muscles in patients with advanced chronic heart failure.