当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Exercise limitation in chronic heart failure: central role of the periphery.

Exercise limitation in chronic heart failure: central role of the periphery.

Abstract：

:The symptoms of chronic heart failure (CHF) are predominantly shortness of breath and fatigue during exercise and reduced exercise capacity. Disturbances of central hemodynamic function are no longer considered to be the major determinants of exercise capacity. The two symptoms of fatigue and breathlessness are often considered in isolation. A pulmonary abnormality is usually considered to be the cause of abnormal ventilation, and increased dead space ventilation has come to be accepted as a major cause of the increased ventilation relative to carbon dioxide production seen in CHF. Rather than decreased skeletal muscle perfusion, an intrinsic muscle abnormality is considered to be responsible for fatigue. Another abnormality seen in CHF is persistent sympathetic nervous system activation, which is difficult to explain on the basis of baroreflex activation. There is increasing evidence for the importance of skeletal muscle ergoreceptors or metaboreceptors in CHF. These receptors are sensitive to work performed, and activation results in increased ventilation and sympathetic activation. The ergoreflex appears to be greatly enhanced in CHF. We put forward the "muscle hypothesis" as an explanation for many of the pathophysiologic events in CHF. Impaired skeletal muscle function results in ergoreflex activation. In turn, this causes increased ventilation, thus linking the symptoms of breathlessness and fatigue. Furthermore, ergoreflex stimulation may be responsible for persistent sympathetic activation.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Clark AL,Poole-Wilson PA,Coats AJ

doi

10.1016/S0735-1097(96)00323-3

subject

Has Abstract

pub_date

1996-11-01 00:00:00

pages

1092-102

issue

5

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(96)00323-3

journal_volume

28

pub_type

杂志文章,评审

相关文献

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY文献大全
  • Multicenter intravascular ultrasound validation study among heart transplant recipients: outcomes after five years.

    abstract：OBJECTIVES:We sought to assess the validity of first-year intravascular ultrasound (IVUS) data as a surrogate marker for long-term outcome after heart transplantation. BACKGROUND:Cardiac allograft vasculopathy (CAV) is a major impediment to long-term graft survival. Intravascular ultrasound is more sensitive than coro...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/j.jacc.2005.02.035

    authors： Kobashigawa JA,Tobis JM,Starling RC,Tuzcu EM,Smith AL,Valantine HA,Yeung AC,Mehra MR,Anzai H,Oeser BT,Abeywickrama KH,Murphy J,Cretin N

    更新日期：2005-05-03 00:00:00

  • Coronary flow velocity response to adenosine characterizes coronary microvascular function in women with chest pain and no obstructive coronary disease. Results from the pilot phase of the Women's Ischemia Syndrome Evaluation (WISE) study.

    abstract：OBJECTIVES:We sought to develop and validate a definition of coronary microvascular dysfunction in women with chest pain and no significant epicardial obstruction based on adenosine-induced changes in coronary flow velocity (i.e., coronary velocity reserve). BACKGROUND:Chest pain is frequently not caused by fixed obst...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(99)00072-8

    authors： Reis SE,Holubkov R,Lee JS,Sharaf B,Reichek N,Rogers WJ,Walsh EG,Fuisz AR,Kerensky R,Detre KM,Sopko G,Pepine CJ

    更新日期：1999-05-01 00:00:00

  • Primary results of the Rapid Emergency Department Heart Failure Outpatient Trial (REDHOT). A multicenter study of B-type natriuretic peptide levels, emergency department decision making, and outcomes in patients presenting with shortness of breath.

    abstract：OBJECTIVES:The purpose of this study was to examine the relationships among B-type natriuretic peptide (BNP) levels within the diagnostic range, perceived congestive heart failure (CHF) severity, clinical decision making, and outcomes of the CHF patients presenting to emergency department (ED). BACKGROUND:Since BNP co...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章,多中心研究

    doi：10.1016/j.jacc.2004.06.015

    authors： Maisel A,Hollander JE,Guss D,McCullough P,Nowak R,Green G,Saltzberg M,Ellison SR,Bhalla MA,Bhalla V,Clopton P,Jesse R,Rapid Emergency Department Heart Failure Outpatient Trial investigators.

    更新日期：2004-09-15 00:00:00

  • Experimental validation of circumferential, longitudinal, and radial 2-dimensional strain during dobutamine stress echocardiography in ischemic conditions.

    abstract：OBJECTIVES:The aim of this study was to assess and validate 2-dimensional (2D) strain for the detection of ischemia during dobutamine stress echocardiography (DSE). BACKGROUND:Evaluation of abnormalities of left ventricular (LV) function from wall thickening during DSE is unsatisfactory and requires a high level of ex...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2007.07.088

    authors： Reant P,Labrousse L,Lafitte S,Bordachar P,Pillois X,Tariosse L,Bonoron-Adele S,Padois P,Deville C,Roudaut R,Dos Santos P

    更新日期：2008-01-15 00:00:00

  • External Aortic Root Support to Prevent Aortic Dilatation in Patients With Marfan Syndrome.

    abstract：BACKGROUND:Personalized external aortic root support (PEARS) was introduced in 2004 for prevention of aortic root dilatation in Marfan patients. The individual's aortic root is replicated by 3-dimensional printing. A polymer mesh sleeve is manufactured, which is implanted with the aim to support and stabilize the aorti...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2018.06.053

    authors： Izgi C,Newsome S,Alpendurada F,Nyktari E,Boutsikou M,Pepper J,Treasure T,Mohiaddin R

    更新日期：2018-09-04 00:00:00

  • Resistance exercise training restores bone mineral density in heart transplant recipients.

    abstract：OBJECTIVES:This was a prospective, randomized, controlled study designed to determine the effect of resistance exercise training on bone metabolism in heart transplant recipients. BACKGROUND:Osteoporosis frequently complicates heart transplantation. No preventative strategy is generally accepted for glucocorticoid-ind...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0735-1097(96)00347-6

    authors： Braith RW,Mills RM,Welsch MA,Keller JW,Pollock ML

    更新日期：1996-11-15 00:00:00

  • The role of percutaneous aortic balloon valvuloplasty in patients with cardiogenic shock and critical aortic stenosis.

    abstract：OBJECTIVES:The goal of this study was to evaluate the role of percutaneous aortic valvuloplasty in patients with cardiogenic shock due to severe aortic stenosis and associated major comorbid conditions and to establish predictors of survival. BACKGROUND:The prognosis for patients in cardiogenic shock with severe aorti...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(94)90592-4

    authors： Moreno PR,Jang IK,Newell JB,Block PC,Palacios IF

    更新日期：1994-04-01 00:00:00

  • Myocardial creatine kinase expression after left ventricular assist device support.

    abstract：OBJECTIVES:We examined whether unloading of the left ventricle with a ventricular assist device (LVAD) can result in normalization of the creatine kinase (CK) abnormalities in the failing human heart. BACKGROUND:Left ventricular failure is associated with a decrease of myocardial total CK activity and a fetal shift in...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(02)01860-0

    authors： Park SJ,Zhang J,Ye Y,Ormaza S,Liang P,Bank AJ,Miller LW,Bache RJ

    更新日期：2002-06-05 00:00:00

  • Morphologic comparison of patients with mitral valve prolapse who died suddenly with patients who died from severe valvular dysfunction or other conditions.

    abstract：:Clinical and necropsy findings are described in 56 patients with mitral valve prolapse: 15 patients, aged 16 to 69 years (mean 39), died suddenly and mitral valve prolapse was the only cardiac condition found at necropsy (hereafter called isolated mitral valve prolapse); the remaining 41 patients had other conditions ...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(91)90875-a

    authors： Dollar AL,Roberts WC

    更新日期：1991-03-15 00:00:00

  • Effects of reperfusion on complete heart block complicating anterior myocardial infarction.

    abstract：:Two patients with complete heart block complicating extensive anterior myocardial infarction underwent late (greater than 40 hours) coronary reperfusion with angioplasty. One to one atrioventricular conduction was restored within minutes of reperfusion despite a lack of measurable ventricular muscle salvage as demonst...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(84)80156-4

    authors： Wilber D,Walton J,O'Neill W,Laufer N,Pitt B

    更新日期：1984-12-01 00:00:00

  • Physiologic correlates of the heart rate response to upright isotonic exercise: relevance to rate-responsive pacemakers.

    abstract：:Rate-responsive cardiac pacing requires a sensitive physiologic variable that is closely correlated with the heart rate-oxygen uptake relation, particularly in patients with heart failure whose cardiac output response to exercise is more dependent on heart rate. Accordingly, the heart rate response to upright exercise...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(88)90172-6

    authors： McElroy PA,Janicki JS,Weber KT

    更新日期：1988-01-01 00:00:00

  • Aspirin resistance and atherothrombotic disease.

    abstract：:Acute coronary syndromes and other manifestations of atherothrombotic disease are primarily caused by atherosclerotic plaque rupture or fissuring and subsequent occlusive or subocclusive thrombus formation. Platelets play a critical role in the pathophysiology of atherothrombotic disease, and aspirin is the most commo...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jacc.2004.08.070

    authors： Mason PJ,Jacobs AK,Freedman JE

    更新日期：2005-09-20 00:00:00

  • Therapeutic update: non-selective beta- and alpha-adrenergic blockade in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure.

    abstract：:Patients with chronic heart failure (CHF) have a resting restrictive ventilatory defect. Any type of exercise requires patients with CHF to markedly increase their minute ventilation. Patients with chronic obstructive pulmonary disease (COPD) have airflow obstruction that leads to dynamic lung hyperinflation and reduc...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jacc.2004.03.063

    authors： Sirak TE,Jelic S,Le Jemtel TH

    更新日期：2004-08-04 00:00:00

  • Left ventricular systolic and diastolic function during acute coronary artery balloon occlusion in humans.

    abstract：:Left ventricular function during percutaneous transluminal coronary angioplasty was studied in 16 patients undergoing the procedure. All measurements were performed before and during the first episode of balloon coronary occlusion. In 16 patients (Group A), data were recorded before and 30 or 50 s after balloon inflat...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(88)90403-2

    authors： Bertrand ME,Lablanche JM,Fourrier JL,Traisnel G,Mirsky I

    更新日期：1988-08-01 00:00:00

  • Lipoprotein-associated phospholipase A2 is an independent predictor of incident coronary heart disease in an apparently healthy older population: the Rancho Bernardo Study.

    abstract：OBJECTIVES:Lipoprotein-associated phospholipase A2 (Lp-PLA2) levels predict incident coronary heart disease (CHD) in adults without known CHD, independent of heart disease risk factors. We examined whether the independent association was apparent in older adults. BACKGROUND:Serum levels of Lp-PLA2, an enzyme that hydr...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2007.10.048

    authors： Daniels LB,Laughlin GA,Sarno MJ,Bettencourt R,Wolfert RL,Barrett-Connor E

    更新日期：2008-03-04 00:00:00

  • The World Trade Center attack: increased frequency of defibrillator shocks for ventricular arrhythmias in patients living remotely from New York City.

    abstract：OBJECTIVES:The goal of this study was to determine whether the World Trade Center (WTC) attack on September 11, 2001, had an effect on the occurrence of ventricular arrhythmias among patients with implantable cardioverter-defibrillators (ICDs) living in Florida. BACKGROUND:Increased frequencies of ICD therapies for ve...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2004.04.058

    authors： Shedd OL,Sears SF Jr,Harvill JL,Arshad A,Conti JB,Steinberg JS,Curtis AB

    更新日期：2004-09-15 00:00:00

  • Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women's Health Initiative.

    abstract：BACKGROUND:Reproductive factors reflective of endogenous sex hormone exposure might have an effect on cardiac remodeling and the development of heart failure (HF). OBJECTIVES:This study examined the association between key reproductive factors and the incidence of HF. METHODS:Women from a cohort of the Women's Health...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2017.03.557

    authors： Hall PS,Nah G,Howard BV,Lewis CE,Allison MA,Sarto GE,Waring ME,Jacobson LT,Manson JE,Klein L,Parikh NI

    更新日期：2017-05-23 00:00:00

  • Advances and Future Directions in Cardiac Pacemakers: Part 2 of a 2-Part Series.

    abstract：:In the second part of this 2-part series on pacemakers, we present recent advances in pacemakers and preview future developments. Cardiac resynchronization therapy (CRT) is a potent treatment for heart failure in the setting of ventricular dyssynchrony. Successful CRT using coronary venous pacing depends on appropriat...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jacc.2016.10.064

    authors： Madhavan M,Mulpuru SK,McLeod CJ,Cha YM,Friedman PA

    更新日期：2017-01-17 00:00:00

  • Smokeless tobacco as a possible risk factor for myocardial infarction: a population-based study in middle-aged men.

    abstract：OBJECTIVES:To explore whether the use of snuff affects the risk of myocardial infarction (MI). BACKGROUND:Snuff and other forms of smokeless tobacco are widely used in some populations. Possible health hazards associated with the use of smokeless tobacco remain controversial. METHODS:In a population-based study withi...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(99)00409-x

    authors： Huhtasaari F,Lundberg V,Eliasson M,Janlert U,Asplund K

    更新日期：1999-11-15 00:00:00

  • Pulsed laser and thermal ablation of atherosclerotic plaque: morphometrically defined surface thrombogenicity in studies using an annular perfusion chamber.

    abstract：:Although clinical trials using laser and thermal angioplasty devices have been underway, the effects of pulsed laser and thermal ablation of atherosclerotic plaque on surface thrombogenicity are poorly understood. This study examined the changes in platelet adherence and thrombus formation on freshly harvested atheros...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(92)90301-3

    authors： Lawrence JB,Prevosti LG,Kramer WS,Smith PD,Bonner RF,Lu DY,Leon MB

    更新日期：1992-04-01 00:00:00

  • Rationale and design of the International Verapamil SR/Trandolapril Study (INVEST): an Internet-based randomized trial in coronary artery disease patients with hypertension.

    abstract：OBJECTIVES:The primary objective of the International Verapamil SR/Trandolapril Study (INVEST) is to compare the risk for adverse outcomes (all-cause mortality, nonfatal myocardial infarction [MI] or nonfatal stroke) in hypertensive patients with coronary artery disease (CAD) treated with either a calcium antagonist-ba...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章,多中心研究,随机对照试验

    doi：10.1016/s0735-1097(98)00423-9

    authors： Pepine CJ,Handberg-Thurmond E,Marks RG,Conlon M,Cooper-DeHoff R,Volkers P,Zellig P

    更新日期：1998-11-01 00:00:00

  • Quantification of renal blood flow with contrast-enhanced ultrasound.

    abstract：OBJECTIVES:The goal of this study was to determine the ability of contrast-enhanced ultrasound (CEU) to quantify renal tissue perfusion. BACKGROUND:The kinetics of tracers used to assess renal perfusion are often complicated by countercurrent exchange, tubular transport or glomerular filtration. We hypothesized that, ...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(00)01210-9

    authors： Wei K,Le E,Bin JP,Coggins M,Thorpe J,Kaul S

    更新日期：2001-03-15 00:00:00

  • Atorvastatin but not L-arginine improves endothelial function in type I diabetes mellitus: a double-blind study.

    abstract：OBJECTIVES:We sought to determine the effects of oral L-arginine and the hexamethylglutaryl coenzyme A reductase inhibitor atorvastatin on endothelial function in young patients with type I diabetes mellitus (DM). BACKGROUND:Endothelial dysfunction, a key early event in atherosclerosis, occurs in young patients with t...

    journal_title：Journal of the American College of Cardiology

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/s0735-1097(00)00743-9

    authors： Mullen MJ,Wright D,Donald AE,Thorne S,Thomson H,Deanfield JE

    更新日期：2000-08-01 00:00:00

  • The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events.

    abstract：OBJECTIVES:The impact of infection-associated antiphospholipid antibodies (APA) on endothelial cell activation, blood coagulation and fibrinolysis was evaluated in patients with infective endocarditis with and without major embolic events. BACKGROUND:An embolic event is a common and severe complication of infective en...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(99)00024-8

    authors： Kupferwasser LI,Hafner G,Mohr-Kahaly S,Erbel R,Meyer J,Darius H

    更新日期：1999-04-01 00:00:00

  • Influence of age and gender on the presence of coronary calcium detected by ultrafast computed tomography.

    abstract：OBJECTIVES:This study sought to determine the relation between coronary calcification detected with ultrafast computed tomography and lumen narrowing defined with angiography and evaluated whether this relation is influenced by age and gender. BACKGROUND:Ultrafast computed tomography has been shown to be a sensitive m...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(94)00342-n

    authors： Devries S,Wolfkiel C,Fusman B,Bakdash H,Ahmed A,Levy P,Chomka E,Kondos G,Zajac E,Rich S

    更新日期：1995-01-01 00:00:00

  • Prognostic significance of silent myocardial ischemia in patients with unstable angina.

    abstract：:Silent myocardial ischemia is common in unstable angina, but its prognostic significance is unknown. Fifty-two (42 with subsequent angiography) of 81 patients prospectively evaluated for unstable angina had ambulatory electrocardiographic (Holter) recordings analyzed by compact analog technique after they had received...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(87)80152-3

    authors： Nademanee K,Intarachot V,Josephson MA,Rieders D,Vaghaiwalla Mody F,Singh BN

    更新日期：1987-07-01 00:00:00

  • Effects of angiotensin II on expression of the gap junction channel protein connexin43 in neonatal rat ventricular myocytes.

    abstract：OBJECTIVES:To elucidate signal transduction pathways regulating expression of myocardial gap junction channel proteins (connexins) and to determine whether mediators of cardiac hypertrophy might promote remodeling of gap junctions, we characterized the effects of angiotensin II on expression of the major cardiac gap ju...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/s0735-1097(98)00317-9

    authors： Dodge SM,Beardslee MA,Darrow BJ,Green KG,Beyer EC,Saffitz JE

    更新日期：1998-09-01 00:00:00

  • Intracoronary stents: will they fulfill their promise as an adjunct to angioplasty?

    abstract：:Coronary angioplasty as it is now performed has several limitations, including abrupt early arterial closure and delayed restenosis. To obviate these problems and to enhance the safety of the technique, several intracoronary stenting devices have been developed and are under investigation. This report reviews the scie...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章,评审

    doi：10.1016/0735-1097(89)90323-9

    authors： Ellis SG,Topol EJ

    更新日期：1989-05-01 00:00:00

  • Impact of valve prosthesis-patient mismatch on pulmonary arterial pressure after mitral valve replacement.

    abstract：OBJECTIVES:We sought to determine the impact of valve prosthesis-patient mismatch (PPM) on pulmonary arterial (PA) pressure after mitral valve replacement (MVR). BACKGROUND:Pulmonary arterial hypertension is a serious complication of mitral valve disease, and it is a major risk factor for poor outcome after MVR. We hy...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/j.jacc.2004.10.073

    authors： Li M,Dumesnil JG,Mathieu P,Pibarot P

    更新日期：2005-04-05 00:00:00

  • Risk stratification before thrombolytic therapy in patients with acute myocardial infarction. The Thrombolysis in Myocardial Infarction (TIMI) Phase II Co-Investigators.

    abstract：:Several studies in the prethrombolytic era on the treatment of acute myocardial infarction identified selected variables from the patient's history, physical examination, chest roentgenogram and electrocardiogram that could be used to estimate mortality in patients with evolving infarction. To extend such assessment t...

    journal_title：Journal of the American College of Cardiology

    pub_type： 杂志文章

    doi：10.1016/0735-1097(90)90579-e

    authors： Hillis LD,Forman S,Braunwald E

    更新日期：1990-08-01 00:00:00