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Background-The muscle hypothesis implicates abnormalities in peripheral muscle as a source for the stimulus to the symptoms and reflex abnormalities seen in chronic heart failure (CHF). We investigated the relationship between skeletal muscle mass (with dual-energy x-ray absorptiometry) and activation of the ergoreflex (a peripheral reflex originating in skeletal muscle sensitive to products of muscle work) in CHF patients and whether this rapport is affected by the progression of the syndrome. Methods and Results-We assessed 107 consecutive CHF patients (mean age, 61.9Ϯ10.9 years; 95% male; 25 cachectics) and 24 age-matched normal subjects (mean age, 59.0Ϯ11.1 years; 91% male). Compared with normal subjects, patients had a higher ergoreflex (in ventilation, 6.2Ϯ.6.1 versus 0.6Ϯ0.6 L/min; PϽ0.0001) and a reduction in muscle mass (51.9Ϯ10.0 versus 60.3Ϯ8.8 kg; PϽ0.001). The ergoreflex was particularly overactive in cachectics (PϽ0.05), accompanied by marked muscle mass depletion (PϽ0.0005). In CHF, ergoreceptor hyperresponsiveness in both the arm and leg correlated with reduced muscle mass, abnormal indexes of exercise tolerance (peak V O 2 , V E/V CO 2 slope), ejection fraction, and NYHA functional class (PϽ0.0001). In the cachectic population, the ventilatory response from ergoreflex to arm exercise was strongly inversely correlated with arm (rϭϪ0.65), leg (rϭϪ0.64), and total (rϭϪ0.61) lean tissues (PϽ0.001 for all). Multivariate analysis showed that these relationships were independent of NYHA class, peak V O 2 , and V E/V CO 2 slope. Conclusions-Depleted

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Multiplex PCR was used to detect genes encoding selected virulence determinants associated with strains of Escherichia coli with K1 antigen (K1 + ) and non-K1 E. coli (K1 " ). The prevalence of the fimA, fimH, sfa/foc, ibeA, iutA and hlyF genes was studied for 134 (67 K1 + and 67 K1 " ) E. coli strains isolated from pregnant women and neonates. The fimA gene was present in 83.6 % of E. coli K1 + and in 86.6 % of E. coli K1 " strains. The fimH gene was present in all tested E. coli K1 + strains and in 97.0 % of non-K1 strains. E. coli K1 + strains were significantly more likely to possess the following genes than E. coli K1 " strains: sfa/foc (37.3 vs 16.4 %, P50.006), ibeA (35.8 vs 4.5 %, P,0.001), iutA (82.1 vs 35.8 %, P,0.001) and hlyF (28.4 vs 6.0 %, P,0.001).In conclusion, E. coli K1 + seems to be more virulent than E. coli K1 " strains in developing severe infections, thereby increasing possible sepsis or neonatal bacterial meningitis.