Chronic heart failure and exercise intolerance: The hemodynamic paradox

Kent R. Nilsson, Brian D. Duscha, Patrick M. Hranitzky, William E. Kraus

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Heart failure represents a major source of morbidity and mortality in industrialized nations. As the leading hospital diselarge diagnosis in the United States in patients over the age of 65, it is also associated with substantial economic costs. While the acute symptoms of volume overload frequently precipitate inpatient admission, it is the symptoms of chronic heart failure, including fatigue, exercise intolerance and exertional dyspnea, that impact quality of life. Over the last two decades, research into the enzymatic, histologic and neurohumoral alterations seen with heart failure have revealed that hemodynamic derangements do not necessarily correlate with symptoms. This "hemodynamic paradox" is explained by alterations in the skeletal musculature that occur in response to hemodynamic derangements. Importantly, gender specific effects appear to modify both disease pathophysiology and response to therapy. The following review will discuss our current understanding of the systemic effects of heart failure before examining how exercise training and cardiac resynchronization therapy may impact disease course.

Original languageEnglish (US)
Pages (from-to)92-100
Number of pages9
JournalCurrent Cardiology Reviews
Volume4
Issue number2
DOIs
StatePublished - May 1 2008

Fingerprint

Heart Failure
Hemodynamics
Exercise
Cardiac Resynchronization Therapy
Developed Countries
Dyspnea
Fatigue
Inpatients
Economics
Quality of Life
Morbidity
Costs and Cost Analysis
Mortality
Research
Therapeutics

Keywords

  • Cardiac
  • Chronic heart failure
  • Exercise
  • Gender
  • Resynchronization therapy (CRT)
  • Skeletal muscle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chronic heart failure and exercise intolerance : The hemodynamic paradox. / Nilsson, Kent R.; Duscha, Brian D.; Hranitzky, Patrick M.; Kraus, William E.

In: Current Cardiology Reviews, Vol. 4, No. 2, 01.05.2008, p. 92-100.

Research output: Contribution to journalReview article

Nilsson, Kent R. ; Duscha, Brian D. ; Hranitzky, Patrick M. ; Kraus, William E. / Chronic heart failure and exercise intolerance : The hemodynamic paradox. In: Current Cardiology Reviews. 2008 ; Vol. 4, No. 2. pp. 92-100.
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