title: Analysis of Skeletal Muscle Torque Capacity and Circulating Ceramides in Patients with Advanced Heart Failure.
abstract: BACKGROUND
  Heart failure (HF)-related exercise intolerance is thought to be perpetuated by peripheral skeletal muscle functional, structural, and metabolic abnormalities. We analyzed specific dynamics of muscle contraction in patients with HF compared with healthy, sedentary controls.
  
  
  METHODS
  Isometric and isokinetic muscle parameters were measured in the dominant upper and lower limbs of 45 HF patients and 15 healthy age-matched controls. Measurements included peak torque normalized to body weight, work normalized to body weight, power, time to peak torque, and acceleration and deceleration to maximum strength times. Body morphometry (dual energy X-ray absorptiometry scan) and circulating fatty acids and ceramides (lipodomics) were analyzed in a subset of subjects (18 HF and 9 controls).
  
  
  RESULTS
  Extension and flexion time-to-peak torque was longer in the lower limbs of HF patients. Furthermore, acceleration and deceleration times in the lower limbs were also prolonged in HF subjects. HF subjects had increased adiposity and decreased lean muscle mass compared with controls. Decreased circulating unsaturated fatty acids and increased ceramides were found in subjects with HF.
  
  
  CONCLUSIONS
  Delayed torque development suggests skeletal muscle impairments that may reflect abnormal neuromuscular functional coupling. These impairments may be further compounded by increased adiposity and inflammation associated with increased ceramides.
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York. Electronic address: dlt2127@cumc.columbia.edu.
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Brunjes
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Dunlop
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Christina
authors.initials: C
authors.lastname: Wu
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Jones
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Tomoko S
authors.initials: TS
authors.lastname: Kato
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kennel
authors.affiliation: Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Hilary F
authors.initials: HF
authors.lastname: Armstrong
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Tse-Hwei
authors.initials: TH
authors.lastname: Choo
authors.affiliation: Department of Rehabilitation Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York.
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Bartels
authors.affiliation: Section of Geriatric Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Forman
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Mancini
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.
authors.forename: P Christian
authors.initials: PC
authors.lastname: Schulze
mesh_terms: D050154:Adiposity; D000328:Adult; D001696:Biomechanical Phenomena; D002518:Ceramides / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D009119:Muscle Contraction / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology*; D019415:Torque
chemical_list: D002518:Ceramides; D005231:Fatty Acids, Unsaturated
keywords: Heart failure; skeletal muscle function; time to peak torque