Metabolic Exploration of Muscle Biopsy

It has been well established that in several chronic diseases such as in chronic obstructive pulmonary disease (COPD), diabetes, cancer or congestive heart failure patients, next to central dysfunctions, the patients develop some systemic consequences that can lead to peripheral muscle dysfunction. Some important clinical implications such as reduced exercise capacity, reduced quality of life and lower survival in these patients are related to changes in muscle structure (mass) and function (power and endurance) (Maltais et al., 1996; 1999; Mettauer et al., 2006). In chronic disease, peripheral perturbations generally include neurohormonal and inflammatory changes, microvascular dysfunction, endothelial abnormalities, tissue wasting, apoptosis and energetic imbalance in skeletal muscle cells, causing reduced exercise capacity. These multisystem abnormalities contribute to the progressive worsening of the disease, and ultimately, lead to premature death. Among the numerous skeletal muscle cell changes that occur in chronic disease, energetic dysfunction has received renewed attention in the last decade and is increasingly considered to be a possible unifying mechanism in the development of muscle failure (Mettauer et al., 2006).