Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1986 Jan;55(1):75–80. doi: 10.1136/hrt.55.1.75

Abnormalities of the peripheral circulation and respiratory function in patients with severe heart failure.

A J Cowley, K Stainer, J M Rowley, J R Hampton
PMCID: PMC1232071  PMID: 3947485

Abstract

To investigate the peripheral circulatory and respiratory abnormalities which occur in patients with heart failure, forearm and calf blood flow were measured before and after upright exercise, and respiratory gas exchange was measured during exercise in 26 patients with severe heart failure. Compared with a group of normal subjects the patients had reduced limb blood flow at rest and the response of limb blood flow to upright exercise was also abnormal. The increase in calf blood flow after exercise and the reduction in blood flow in the non-exercising forearm were both smaller in patients than in controls. There was a significant correlation between the maximum exercise duration of the patients and calf blood flow both after exercise and at rest. Compared with another group of control subjects the patients had a higher minute ventilation during exercise and a reduced oxygen consumption. The respiratory exchange ratio during exercise was also higher in patients than in controls. This suggests that there is early onset of anaerobic metabolism during exercise in patients with severe heart failure.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cohn J. N. Physiologic basis of vasodilator therapy for heart failure. Am J Med. 1981 Jul;71(1):135–139. doi: 10.1016/0002-9343(81)90276-x. [DOI] [PubMed] [Google Scholar]
  2. Cowley A. J., Rowley J. M., Stainer K. L., Hampton J. R. Captopril therapy for heart failure. A placebo controlled study. Lancet. 1982 Oct 2;2(8301):730–732. doi: 10.1016/s0140-6736(82)90920-5. [DOI] [PubMed] [Google Scholar]
  3. Faxon D. P., Halperin J. L., Creager M. A., Gavras H., Schick E. C., Ryan T. J. Angiotensin inhibition in severe heart failure: acute central and limb hemodynamic effects of captopril with observations on sustained oral therapy. Am Heart J. 1981 May;101(5):548–556. doi: 10.1016/0002-8703(81)90220-9. [DOI] [PubMed] [Google Scholar]
  4. Fitchett D. H., Neto J. A., Oakley C. M., Goodwin J. F. Hydralazine in the management of left ventricular failure. Am J Cardiol. 1979 Aug;44(2):303–309. doi: 10.1016/0002-9149(79)90321-7. [DOI] [PubMed] [Google Scholar]
  5. Franciosa J. A., Park M., Levine T. B. Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure. Am J Cardiol. 1981 Jan;47(1):33–39. doi: 10.1016/0002-9149(81)90286-1. [DOI] [PubMed] [Google Scholar]
  6. Franciosa J. A., Ziesche S., Wilen M. Functional capacity of patients with chronic left ventricular failure. Relationship of bicycle exercise performance to clinical and hemodynamic characterization. Am J Med. 1979 Sep;67(3):460–466. doi: 10.1016/0002-9343(79)90794-0. [DOI] [PubMed] [Google Scholar]
  7. GREENFIELD A. D., WHITNEY R. J., MOWBRAY J. F. Methods for the investigation of peripheral blood flow. Br Med Bull. 1963 May;19:101–109. doi: 10.1093/oxfordjournals.bmb.a070026. [DOI] [PubMed] [Google Scholar]
  8. HUCKABEE W. E., JUDSON W. E. The role of anaerobic metabolism in the performance of mild muscular work. I. Relationship to oxygen consumption and cardiac output, and the effect of congestive heart failure. J Clin Invest. 1958 Nov;37(11):1577–1592. doi: 10.1172/JCI103751. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Longhurst J., Gifford W., Zelis R. Impaired forearm oxygen consumption during static exercise in patients with congestive heart failure. Circulation. 1976 Sep;54(3):477–480. doi: 10.1161/01.cir.54.3.477. [DOI] [PubMed] [Google Scholar]
  10. Maslowski A. H., Ikram H., Nicholls M. G., Espiner E. A. Haemodynamic, hormonal, and electrolyte responses to captopril in resistant heart failure. Lancet. 1981 Jan 10;1(8211):71–74. doi: 10.1016/s0140-6736(81)90004-0. [DOI] [PubMed] [Google Scholar]
  11. Mason D. T., Zelis R., Longhurst J., Lee G. Cardiocirculatory responses to muscular exercise in congestive heart failure. Prog Cardiovasc Dis. 1977 May-Jun;19(6):475–489. doi: 10.1016/0033-0620(77)90011-1. [DOI] [PubMed] [Google Scholar]
  12. Massie B. M., Kramer B. L., Topic N. Lack of relationship between the short-term hemodynamic effects of captopril and subsequent clinical responses. Circulation. 1984 Jun;69(6):1135–1141. doi: 10.1161/01.cir.69.6.1135. [DOI] [PubMed] [Google Scholar]
  13. Patterson J. A., Naughton J., Pietras R. J., Gunnar R. M. Treadmill exercise in assessment of the functional capacity of patients with cardiac disease. Am J Cardiol. 1972 Nov;30(7):757–762. doi: 10.1016/0002-9149(72)90151-8. [DOI] [PubMed] [Google Scholar]
  14. Rubin S. A., Chatterjee K., Parmley W. W. Metabolic assessment of exercise in chronic heart failure patients treated with short-term vasodilators. Circulation. 1980 Mar;61(3):543–548. doi: 10.1161/01.cir.61.3.543. [DOI] [PubMed] [Google Scholar]
  15. Williams D. O., Bommer W. J., Miller R. R., Amsterdam E. A., Mason D. T. Hemodynamic assessment of oral peripheral vasodilator therapy in chronic congestive heart failure: prolonged effectiveness of isosorbide dinitrate. Am J Cardiol. 1977 Jan;39(1):84–90. doi: 10.1016/s0002-9149(77)80016-7. [DOI] [PubMed] [Google Scholar]
  16. Wilson J. R., Fink L., Maris J., Ferraro N., Power-Vanwart J., Eleff S., Chance B. Evaluation of energy metabolism in skeletal muscle of patients with heart failure with gated phosphorus-31 nuclear magnetic resonance. Circulation. 1985 Jan;71(1):57–62. doi: 10.1161/01.cir.71.1.57. [DOI] [PubMed] [Google Scholar]
  17. Wilson J. R., Martin J. L., Schwartz D., Ferraro N. Exercise intolerance in patients with chronic heart failure: role of impaired nutritive flow to skeletal muscle. Circulation. 1984 Jun;69(6):1079–1087. doi: 10.1161/01.cir.69.6.1079. [DOI] [PubMed] [Google Scholar]
  18. Zelis R., Longhurst J., Capone R. J., Mason D. T. A comparison of regional blood flow and oxygen utilization during dynamic forearm exercise in normal subjects and patients with congestive heart failure. Circulation. 1974 Jul;50(1):137–143. doi: 10.1161/01.cir.50.1.137. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES