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Microvascular endothelial dysfunction in heart failure patients: An indication for exercise treatment?
Lukas Streese1, Giulia Lona1, Jonathan Wagner1
1Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland.
Retinal vessel analysis in chronic heart failure (CHF) patients revealed impaired microvascular function, indicated by reduced arteriolar flicker-light induced dilatation (aFID). Exercise intervention showed potential for improving retinal microvascular health in CHF patients.
Area of Science:
- Ophthalmology
- Cardiology
- Vascular Biology
Background:
- Endothelial dysfunction is a key marker for chronic heart failure (CHF) severity.
- Retinal vessel phenotyping offers a sensitive method to assess microvascular health and cardiovascular risk.
Observation:
- Central retinal arteriolar (CRAE) and venular equivalents (CRVE) were analyzed in 26 CHF patients and 26 controls.
- Retinal microvascular function was quantified using arteriolar (aFID) and venular flicker-light induced dilatation (vFID).
- A single CHF patient underwent a 12-week exercise intervention to assess its impact on retinal microvasculature.
Findings:
- CHF patients exhibited a significantly lower arteriolar-to-venular diameter ratio (AVR) compared to controls (p=0.004).
- CHF patients demonstrated significantly reduced aFID (p<0.001) and vFID (p=0.033), indicating impaired microvascular function.
- Exercise therapy in one patient led to wider CRAE, narrower CRVE, and improved aFID.
Implications:
- Arteriolar flicker-light induced dilatation (aFID) serves as a sensitive diagnostic tool for microvascular impairments in CHF.
- Exercise treatment holds promise for enhancing retinal microvascular health in CHF patients, potentially aiding vascular regeneration and risk reduction.
- Further randomized controlled trials are warranted to confirm the benefits of exercise interventions in CHF.
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