Patients with end stage heart failure (HF) exhibit abnormalities in their skeletal muscle, thought to be as a result of reduced blood flow to the muscle as their HF worsens. We will identify the relative nature of these changes by obtaining skeletal muscle biopsies in HF patients as well as healthy control subjects without HF. These biopsies will be from the right upper thigh as well as from the right calf muscle. We will compare these biopsies to identify if the changes we are seeing are in fact more severe in the calf compared to the thigh muscle.