Exercise Dynamic of Patients with Chronic Heart Failure and Reduced Ejection Fraction

Editorial: Exercise and heart failure

“…Therefore, at a first glance exercise limitation is basically due to insufficient or delayed supply of O 2 to the muscle, and in particular to the mitochondria. The proper delivery of oxygen to exercising muscles mitochondria basically depends on three variables: O 2 delivery, pO 2 reduction from arteries to capillaries, and O 2 diffusion from capillaries to the mitochondrion (Wagner, 1992;Wagner, 1996;Rovai et al, 2021).…”

“…The complex adjustment of these three factors is exemplified by Wagner's diagram (Wagner, 1996;Rovai et al, 2021) (Figure 1), which shows:…”

“…It is in fact of crucial importance to translate the application of the results obtained in the laboratory in the patient's daily life, thus not stopping at the fundamental result of improving prognosis, but also focusing on everyday patients' quality of life, considering the data obtained on the ability to perform efforts on a daily basis. Rovai et al, 2021(Rovai et al, 2021.…”

“…During exercise VO 2 increases by three independent mechanisms: (A) increase in O 2 delivery (exerciseinduced cardiac output increase and hemoconcentration (bold lines); (B) pO 2 reduction in the capillary bed (X axis); and (C) differences in O 2 diffusion from the capillary to the mitochondria (dashed lines). Reproduced with permission fromRovai et al, 2021(Rovai et al, 2021.…”