Abstract-Skeletal muscle weakness and decreased exercise capacity are major symptoms reported by patients with congestive heart failure (CHF). Intriguingly, these skeletal muscle symptoms do not correlate with the decreased heart function. This suggests that CHF leads to maladaptive changes in skeletal muscles, and as reported most markedly in slow-twitch muscles. We used rats at 6 weeks after infarction to measure expression of key proteins involved in SR Ca 2ϩ release and uptake in slow-twitch soleus muscles. We also measured force and myoplasmic free [Ca 2ϩ ] ([Ca 2ϩ ] i ) in intact single fibers of soleus muscles. CHF rats showed clear signs of severe cardiac dysfunction with marked increases in heart weight and left ventricular end-diastolic pressure compared with sham operated rats (Sham). There were small, but significant, changes in the content of proteins involved in cellular Ca 2ϩ handling in CHF muscles: slight increases in SR Ca 2ϩ release channels (ie, the ryanodine receptors) and in SR Ca 2ϩ -ATPase. Tetanic force and [Ca 2ϩ ] i were not significantly different between CHF and Sham soleus fibers under resting conditions. However, during the stimulation period there was a decrease in tetanic force without changes in [Ca 2ϩ ] i in CHF fibers that was not observed in Sham fibers. The fatigue-induced changes recovered rapidly. We conclude that CHF soleus fibers fatigue more rapidly than Sham fibers because of a reversible fatigue-induced decrease in myofibrillar function. Key Words: skeletal muscle Ⅲ congestive heart failure Ⅲ muscle fatigue Ⅲ Ca 2ϩ P atients with congestive heart failure (CHF) frequently report skeletal muscle weakness and decreased fatigue resistance. These skeletal muscle symptoms are not correlated with the observed decrease in heart function. 1 This suggests that CHF leads to intrinsic defects in skeletal muscles, and several authors have described important functional and biochemical changes in skeletal muscle cells (for recent reviews see references 2-4). Even so, the mechanism(s) underlying the impaired skeletal muscle function in CHF remains unclear.Impaired sarcoplasmic reticulum (SR) Ca 2ϩ handling has been observed in skeletal muscle cells of rats with CHF induced by myocardial infarction. [5][6][7] Using a rat CHF model at 6 weeks after infarction, we could only detect a subtle slowing of the SR Ca 2ϩ reuptake in single fast-twitch fibers isolated from a foot muscle. 8 However, in our rat model of CHF, changes in contractile function during stimulation are more pronounced in slow-twitch than in fast-twitch skeletal muscle; slow-twitch soleus muscles of CHF rats showed a marked slowing of relaxation followed by a decrease in force development that was not seen in control muscles. 8,9 The aim of the present study was to determine whether skeletal muscle Ca 2ϩ handling and force production in CHF animals were changed at an early time point when changes in protein expression were minimal. Therefore we measured the expression of key proteins involved in SR Ca 2ϩ release ...