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To establish the extent, if any, of peripheral changes in asymptomatic patients with severe left ventricular dysfunction. METHODS ANS RESULTS: Nine asymptomatic and nine symptomatic patients with left ventricular ejection fraction, &lt;25%, matched for age and left ventricular ejection fraction (asymptomatic vs symptomatic, age: 52+/-1.5 vs 55.9+/-2.5 years [Mean+/-SEM], left ventricular ejection fraction: 16+/-2 vs 19+/-2%P=0.23 and 0.48, respectively) were studied and compared with 26 age-matched normal controls. We assessed exercise capacity, leg blood flow (occlusion plethysmography), respiratory muscle strength, quadriceps maximal isometric strength, fatigue and CT cross-sectional muscle area at mid thigh. Fatigue was expressed as the percentage reduction in maximal strength following a 20 min fatiguing protocol. There was a graded increase in peak oxygen consumption comparing symptomatic, asymptomatic and control groups (16.6+/-1.3 vs 27.1+/-1.6 vs 32.8+/-1.3 ml x min(-1) x kg(-1)respectively, ANOVA P&lt;0.0001). Between the three groups there was significant variation in muscle strength (P&lt;0.0001), endurance (P=0.0002) and cross-sectional area (P=0.0003) and in peak blood flow (P=0.027) and respiratory muscle strength (P&lt;0.05). When asymptomatic patients and controls were compared no significant differences existed.

Preservation of exercise capacity and lack of peripheral changes in asymptomatic patients with severely impaired left ventricular function