{"id":"426c7104af7b","type":"article","url":"https://hartvaat.nl/2026/05/05/perifere-zuurstofextractie-bepaalt-belasting-bij-arrhythmogene-cardiomyopathie-f/","title":"Perifere zuurstofextractie bepaalt belasting bij arrhythmogene cardiomyopathie — fysiologisch pleidooi voor veilige training","title_en":"Oxygen utilization during moderate-intensity resistance and aerobic exercise in arrhythmogenic cardiomyopathy: the central role of the periphery.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag163","source_url":"https://doi.org/10.1093/eschf/xvag163","authors":["Simon Wernhart","Manuel Rattka","Marwin Shir","Karl-Ludwig Laugwitz","Martin Halle","Mark J Haykowsky"],"significance":4,"published":"2026-07-31","source_date":"2026-05-05","image":"","kennis":[],"congress":"","summary_en":"In a small mechanistic study (n=19), researchers quantified central oxygen delivery and peripheral extraction during resistance and aerobic exercise in patients with arrhythmogenic cardiomyopathy (ACM). While central oxygen delivery increased only modestly, peripheral oxygen extraction and diffusive conductance rose significantly and accounted for 77% of the variance in whole-body oxygen uptake. These findings suggest that moderate exercise imposes predominantly peripheral, rather than central, physiological stress in ACM, providing a physiological rationale for prescribing safe exercise training in this population.","created":"2026-07-24T00:55:54Z","updated":"2026-08-10T10:37:43Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een kleine cohortstudie (n=19) onderzochten onderzoekers de centrale zuurstoflevering en perifere zuurstofopname tijdens weerstand- en aerobe training bij patiënten met arrhythmogene cardiomyopathie (ACM). Hoewel de centrale zuurstoflevering slechts matig toenam, nam de perifere extractie en diffusiële zuurstofgeleiding (DmO2) significant toe en verklaarde dit 77% van de variatie in zuurstofopname. Deze bevindingen suggereren dat de fysiologische belasting tijdens matige training voornamelijk perifere oorsprong is, wat een fysiologisch onderbouwd pleidooi vormt voor veilige trainingsadviezen in deze patiëntengroep.","abstract_original":"AIMS: To quantify central oxygen delivery (O2D), peripheral oxygen extraction, and muscle diffusive oxygen conductance (DmO2) during upper-extremity resistance and lower-extremity aerobic exercise in patients with arrhythmogenic cardiomyopathy (ACM). METHODS AND RESULTS: Nineteen patients with ACM underwent invasive cardiopulmonary exercise testing with right heart and radial artery catheterization. Participants performed 1-min isometric handgrip (IM-HG) and bicep curl (BC) exercise at 70% maximal voluntary contraction, and 20- and 40-min supine cycling (CYC-20, CYC-40) at the first ventilatory threshold. Exercise pulmonary hypertension, defined by a cardiac output to mean pulmonary artery slope >3 mmHg/L/min, did not occur (mean 0.67 mmHg/L/min). Whole-body oxygen uptake (V̇O2) increased significantly across all modes (P < .001); however, central O2D did not increase significantly during IM-HG or BC and rose only modestly during cycling. In contrast, peripheral O2 extraction and DmO2 increased significantly across all modalities (P < .001). Dominance analysis revealed that DmO2 accounted for 77% of the variance in V̇O2 pooled across all conditions, whereas O2D accounted for only 23%. CONCLUSIONS: Moderate-intensity isometric and dynamic resistance and aerobic exercise in ACM is mediated by a predominantly peripheral, rather than central, physiological stress in our small ACM sample. This may provide preliminary results for a physiological rationale for safe exercise in this population."}