Impaired Microcirculation in Heart Failure

Abstract

The aim of the present study was to examine the nailfold capillary morphology and dynamics in treated chronic heart failure (CHF) in relation to parameters of left ventricular structure and function. Twenty patients with CHF class II according to the New York Heart Association underwent a capillaroscopic examination at the finger nailfold using a computerized videophotometric system (Capiflow®) at rest and after 1 min arterial occlusion. Study parameters ere number, length and diameter of the capillaries as well as capillary blood velocity (CBV). Further experiments included echocardiography and determination of left ventricular ejection fraction by Tc scintigraphy. Nailfold capillaries in established CHF are enlarged and the CBV is dramatically decreased. The reactive hyperemic response to 1 min arterial occlusion is attenuated. CBV correlates positively with left ventricular ejection fraction (r = 0.61, p = 0.01) and inversely with left ventricular end-diastolic (r = -0.56, p = 0.04) and end-systolic (r = -0.69, p = 0.01) diameters. The time-to-peak flow after 1 min arterial occlusion is positively related (r = 0.68, p < 0.05) to the duration of CHF. Our data indicate that finger microcirculation in CHF deteriorates as a function of the severity and duration of heart failure.

Microvascular Abnormalities in Chronic Heart Failure: A Cross‐Sectional Analysis

“…This new balance in the number of perfused arterioles, capillaries, and venules is a characteristic of the autoregulation of an optimal tissue capillary perfusion and pressure. In patients with mild heart failure, a slightly decreased nailfold capillary pressure (21) and capillary blood cell velocity (9) has been demonstrated, compatible with a reduction in postcapillary resistance such as found in this study (an increase in venular density). Whether the observed microvascular changes in mild heart failure are functional or structural is unclear.…”

Oxygenation measurement by multi-wavelength oxygen-dependent phosphorescence and delayed fluorescence: catchment depth and application in intact heart

“…According to these excitation wavelengths optical properties of myocardial tissue and blood were retrieved from the Refs. [49][50][51][52][53][54][55][56][57][58][59][60][61]. Due to the scarce primary data for myocardial tissue, striated muscle and liver data were also gathered for comparison due to their similar absorption and scattering properties (Tables 1, 2).…”

Effects of losartan titrated to losartan/hydrochlorothiazide and amlodipine on blood pressure and peripheral capillary microcirculation in patients with mild-to-moderate hypertension

“…3,4 Moreover, finger microcirculation deteriorates as a function of the severity and duration of chronic heart failure, a common condition observed in end-stage hypertensive heart disease with activated sympathoadrenal tone. 5 Structural changes and reduced density of capilCorrespondence: Dr B Martina, Medical Outpatient Clinic, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland Received 28 November 1997; revised and accepted 18 March 1998 (n = 10) and losartan titrated to losartan-HCT (n = 10) sitting BP decreased significantly from 160 ± 7/103 ± 4 mm Hg and 147 ± 7/98 ± 6 mm Hg to 131 ± 10/86 ± 7 mm Hg and 134 ± 17/89 ± 9 mm Hg, respectively (P Ͻ 0.01). After local finger cooling the area under the curve (AUC) of capillary blood cell velocities was 1.13 ± 0.58 mm (median ± s.d.)…”