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Postural vasoconstrictor response in human heart failure

I R Mahy1, A C Shore, L D Smith

  • 1Department of Vascular Medicine, University of Exeter, UK.

International Journal of Microcirculation, Clinical and Experimental
|May 1, 1995
PubMed
Summary
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Heart failure patients show reduced resting blood flow but maintain normal postural vasoconstriction. This suggests the autonomic nervous system

Area of Science:

  • Cardiovascular Physiology
  • Microcirculation Research
  • Heart Failure Pathophysiology

Background:

  • Heart failure is associated with impaired autonomic function.
  • Cutaneous vascular responses to postural changes are not well understood in heart failure.

Purpose of the Study:

  • To investigate posturally induced vasoconstriction in the cutaneous microcirculation of heart failure patients.
  • To compare responses between sites with and without arteriovenous anastomoses.

Main Methods:

  • Laser Doppler fluximetry was used to measure foot blood flow at rest and during limb lowering.
  • Two distinct foot sites were studied: toe pulp (rich in anastomoses) and dorsum (few anastomoses).
  • Subjects included patients with idiopathic dilated cardiomyopathy and healthy controls.

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Main Results:

  • Heart failure patients exhibited significantly lower resting cutaneous blood flow at both study sites compared to controls.
  • Despite reduced resting flow, the percentage change in blood flow during postural challenge was similar between groups at both sites.
  • This indicates preserved vasoconstrictor responses to postural changes in non-edematous heart failure patients.

Conclusions:

  • Severe left ventricular dysfunction in non-edematous heart failure patients does not significantly impair postural vasoconstriction.
  • The cutaneous microvascular response to postural stress appears intact, even with reduced resting flow.