ALTERATIONS OF RADIAL ARTERY COMPLIANCE IN PATIENTS WITH CONGESTIVE-HEART-FAILURE

Congestive heart failure is accompanied by several hemodynamic alterat ions. To investigate whether these alterations include reduced arteria l compliance, we studied 25 patients (age 57 +/- 2 years, mean +/- SE) with a mild or severe congestive heart failure based on clinical symp toms (New York Heart Association class II vs III or IV) and on echocar diographic alterations of left ventricular diastolic diameter and ejec tion fraction. Radial artery diameter and blood pressure were continuo usly measured by Doppler ultrasonography and a finger pressure device, respectively. Compliance was calculated by the Langewouters formula, and compliance values were derived throughout the systolic-diastolic p ressure range. The area under the compliance-pressure curve normalized for pulse pressure was used to compare compliance values in the vario us groups. Data were obtained both in baseline condition and at the re lease from a 12-minute brachial artery occlusion. Fourteen healthy, ag e-matched subjects served as controls. Compared with the control group , patients with severe congestive heart failure showed a reduction of baseline compliance index (-48%, p <0.01). Furthermore, while in contr ol subjects compliance markedly increased after brachial artery occlus ion (+43%, p <0.01), in patients with severe congestive heart failure no increase occurred. No baseline compliance alteration was seen in pa tients with mild congestive heart failure in whom, however, the postis chemic increase in compliance was also significantly blunted (-50% vs controls, p <0.05). Thus, arterial compliance and arterial compliance modulation are impaired in congestive heart failure. Although more mar ked in severe congestive heart failure, the impairment is manifest in mild congestive heart failure as well.