Skeletal Muscle Structural and Functional Impairments as Important Peripheral Exercise Intolerance Determinants in Pulmonary Arterial Hypertension

Reduced exercise tolerance stands as the foremost symptom, profoundly impacting the lives of those grappling with pulmonary arterial hypertension (PAH). This decline stems from both pulmonary and cardiac irregularities. Nonetheless, there is a burgeoning recognition that dysfunction within peripheral skeletal muscles (SKMs) significantly contributes to compromised exercise capacity. Consequently, the morphological and functional impairments of SKMs, coupled with microvascular loss, proinflammatory states, and oxidative disorders, play substantial roles in limiting exercise capacity in PAH. Regrettably, these facets have only undergone partial scrutiny. Thus, this review aims to spotlight the current body of literature concerning SKM dysfunctions in PAH and pinpoint knowledge gaps warranting further exploration to deepen our comprehension of SKM dysfunction and exercise intolerance in PAH.