REGIONAL SPECIFICITY OF PEAK HYPEREMIC RESPONSE IN PATIENTS WITH CONGESTIVE-HEART-FAILURE - CORRELATION WITH PEAK AEROBIC CAPACITY

Objectives. The aim of this study was to compare peak reactive hyperem ic blood flows in the forearm and calf of patients with congestive hea rt failure and in age and gender matched normal subjects. In addition, we attempted to correlate peak oxygen consumption with forearm and ca lf peak reactive hyperemic hows in the patients with heart failure. Ba ckground. Disparate results have been reported regarding forearm peak reactive hyperemia in patients with congestive heart failure. Because training significantly increases peak reactive hyperemic flow in norma l subjects, we hypothesized that in patients with congestive heart fai lure who curtail walking because of exertional symptoms, calf peak rea ctive hyperemic flow would be preferentially attenuated and that impai rment of calf vasculature may correlate with peak oxygen consumption. Methods. Forearm and calf blood flows were measured by venous occlusiv e plethysmography at rest and after 5 min of arterial occlusion in 46 patients with congestive heart failure and 7 age- and gender-matched n ormal subjects. Peak oxygen consumption was measured during graded exe rcise on a bicycle ergometer. Results. Calf peak reactive hyperemic fl ow was lower in patients with congestive heart failure than in normal subjects (22 +/- 1 vs. 32.5 +/- 3.5 ml/min per 100 ml, p < 0.001), whe reas forearm peak reactive hyperemic flows were similar in the two gro ups. Calf peak reactive hyperemic flow was linearly related to peak ox ygen consumption (r = 0.58, p < 0.0001), but forearm peak reactive hyp eremic flow was not. Forearm and calf peak reactive hyperemic flows we re not related at rest or after 5 min of arterial occlusion in the pat ients with heart failure. Conclusions. Calf peak reactive hyperemic fl ow is reduced in patients with congestive heart failure, whereas forea rm peak reactive hyperemic flow is identical to that of age and gender -matched normal subjects. Calf peak reactive hyperemic flow is linearl y related to peak oxygen consumption in patients with congestive heart failure, but forearm peak reactive hyperemic flow is not.