Targeting leg fatigue in heart failure

Doctors should not only treat the heart muscle in chronic heart failure patients, but also their leg muscles through exercise, say researchers in a major new study. Heart failure causes breathlessness and fatigue that severely limits normal daily activities such as walking. The University of Leeds research team has, for the first time, shown that leg muscle dysfunction is related to the severity of symptoms in heart failure patients. These findings suggest that daily activity in patients with severe heart failure may not simply be limited by the failing heart, but also by an impairment in the leg muscles themselves. In a series of experiments with chronic heart failure patients, the research team measured responses of the heart, lungs and leg muscles following a moderate exercise warm-up. Using a near-infrared laser to measure the oxygenation of the leg muscles, they found that warm-up exercise increased the activity of skeletal muscle enzymes that control energy production. However, this adaptation was less in patients with the most severe symptoms, showing that the heart failure condition had a negative impact on the normal function of the leg muscles.