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      Evidence for Structural Alterations in Resistance Arteries of Patients with Severe Congestive Heart Failure

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          Abstract

          Congestive heart failure (CHF) is characterized by an increase in total peripheral resistance. It was the specific aim of this study to investigate whether structural factors participate in the increased peripheral resistance that can be observed in severe heart failure. We determined forearm vascular resistance (FVR) at rest and after 10 min ischemia (Rmin; mm Hg/ml/min/100 ml) using venous occlusion plethysmography. Rmin was studied since it is largely dependent on the structural characteristics of resistance arteries. 24 patients with CHF [71.5 ± 2.3 years; New York Heart Association (NYHA) functional class I–IV] with no history of arterial hypertension and casual arterial blood pressure < 140/90 mm Hg and 24 normotensive healthy control subjects (52.5 ± 4.1 years) were included in our study. The patients were subdivided into those with ‘mild’ (NYHA class I and II; n = 10) and ‘severe’ (NYHA class III and IV; n = 14) heart failure. There were no significant differences between the two groups for echocardiographically determined ejection fraction and mean arterial blood pressure. Resting FVR averaged 40.5 ± 4.4 mm Hg/ml/min/100 ml in control subjects and was 43.6 ± 7.9 (nonsignificant vs. control) and 51.0 ± 5 mm Hg/ml/min/100 ml (p < 0.05 vs. control) in patients with mild and severe CHF, respectively. No significant correlation between age and Rmin could be demonstrated in either the patient or the control group. Furthermore, Rmin did not differ between patients with mild CHF and control subjects. However, Rmin was significantly elevated in patients with severe CHF (5.7 ± 0.39 mm Hg/ml/min/100 ml) as compared to patients with mild CHF (4.0 ± 0.39 mm Hg/ml/min/100 ml; p < 0.05) and controls (4.5 ± 0.26 mm Hg/ml/min/100 ml; p < 0.05). In conclusion, our study supports the concept that structural alterations contribute to the increased peripheral resistance in patients with heart failure. These changes are correlated with the severity of clinical symptoms.

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          Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure

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            Author and article information

            Journal
            JVR
            J Vasc Res
            10.1159/issn.1018-1172
            Journal of Vascular Research
            S. Karger AG
            1018-1172
            1423-0135
            1999
            June 1999
            18 June 1999
            : 36
            : 3
            : 229-234
            Affiliations
            Medizinische Universitäts-Poliklinik, Bonn, Germany
            Article
            25646 J Vasc Res 1999;36:229–234
            10.1159/000025646
            10393509
            © 1999 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 3, References: 27, Pages: 6
            Categories
            Research Paper

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