F Fi ib br re e t ty yp pe es s iin n s sk ke el le et ta al l m mu us sc cl le es s o of f c ch hr ro on ni ic c o ob bs st tr ru uc ct ti iv ve e p pu ul lm mo on na ar ry y d di is se ea as se e p pa at ti ie en nt ts s r re el la at te ed d t to o r re es sp pi ir ra at to or ry y f fu un nc ct ti io on n a an nd d e ex xe er rc ci is se e t to ol le er ra an nc ce e A group of 22 COPD patients and 10 healthy control subjects were studied. In COPD patients, vital capacity (VC) and forced expiratory volume in one second (FEV1) were reduced to 79% and 51%, respectively. Diffusion indices (transfer factor of the lung for carbon monoxide (TL,CO) and carbon monoxide transfer coefficient (KCO)) were also reduced. Arterial oxygen tension (Pa,O 2 ) was normal or slightly altered. A maximal exercise test was performed and anaerobic threshold was calculated. Muscle samples from vastus lateralis were obtained by needle biopsy. Myosin heavy chain (MHC) and light chain (MLC) isoforms were separated by gel electrophoresis and quantified by densitometry. MHC isoforms were considered as molecular markers of fibre types.The proportion of the fast MHC-2B isoform was increased in COPD patients. TL,CO, KCO, VC and FEV1 were positively correlated with slow MHC isoform content. TL,CO and KCO were also negatively correlated with the content of the fast MHC-2B isoform. No correlation was found between exercise parameters and MHC isoform composition. The co-ordinated expression between MHC and MLC isoforms was altered in COPD patients.We conclude that reduced oxygen availability, probably in combination with muscle disuse, may determine muscle alterations in chronic obstructive pulmonary disease patients. The altered correlations between myosin heavy chain and light chain isoforms suggest that co-ordinated protein expression is lost in chronic obstructive pulmonary disease muscles. Eur Respir J 1997; 10: 2853-2860 Patients with chronic obstructive pulmonary disease (COPD) are characterized by poor quality of life and various degrees of limitation in their daily activity, mainly due to breathlessness. They are often self-limiting their level of activity into a downward spiral leading to further inactivity and muscle deconditioning. Exercise tolerance of COPD patients is determined by the level of ventilation that they can reach. Even at a rather low work rate the increase in ventilatory response and blood lactate concentration are higher than in normal subjects.Rehabilitation of COPD patients involves general exercise reconditioning. This is suggested as the best approach to the rehabilitation of COPD patients, and is usually performed by training large muscles of the lower and, less frequently, upper limbs [1]. The mechanisms underlying the improvement of the performance after general training in COPD subjects are still unclear.There is evidence that skeletal muscle function and structure are altered in COPD patients. Contractile strength is reduced [2] and energetic and oxidative metabolism are impaired [3][4][5]. Fibre-type compos...