Altered Skeletal Muscle Metabolic Response to Exercise in Chronic Heart Failure

Background. Exertional fatigue, which frequently limits exercise in patients with chronic heart failure, is associated with early anaerobic metabolism in skeletal muscle. The present study was designed to examine the skeletal muscle metabolic response to exercise in this disorder and determine the relation of reduced muscle blood flow and skeletal muscle biochemistry and histology to the early onset of anaerobic metabolism in patients. Methods and Results. We evaluated leg blood flow, blood lactate, and skeletal muscle metabolic