Table 1.
Studies on peripheral microvascular function in HFpEF.
| Study Design | HFpEF Population | Control Population | Method (Measurement) | Stimulus | Microvascular Function Assessed | Outcome (SD/IQR) |
|---|---|---|---|---|---|---|
| Skin-finger | ||||||
| Prospective [24] | n = 321 | Controls without HF, matched for age, sex, HT, and DM (n = 173) | Peripheral arterial tonometry (endoPAT): (RHI) | Ischemia | Hyperaemia | Log RHI: 0.53 ± 0.20 vs. 0.64 ± 0.20, p < 0.001 |
| Prospective [10] | n = 202 | No controls | endoPAT (RHI) | Ischemia | Hyperaemia | Log RHI: no absolute values reported. Correlation with CFR of R 0.21, p = 0.004 |
| Retrospective [25] | n = 159 | No controls | endoPAT (RHI) | Ischemia | Hyperaemia | Log RHI: 0.50 ± 0.09. Event free 0.52 ± 0.09 vs. Events 0.46 ± 0.08, p < 0.001 |
| Prospective (cross-sectional) [26] | n = 62 | Controls matched for age, sex, HT, DM, dyslipidaemia and CAD (n = 64) | endoPAT (RHI) | Ischemia | Hyperaemia | RHI: 2.01 [1.64–2.42] vs. 1.70 [1.55–1.88], p < 0.001 |
| Prospective [27] | n = 42 | HFrEF (n = 46) | endoPAT (RHI) | Ischemia | Hyperaemia | RHI: 1.77 [1.67–2.16] vs. 1.53 [1.42–1.94], p = 0.014. |
| Prospective [28] | n = 26 | Healthy controls, matched for age and sex (n = 26) | endoPAT (RHI) | Ischemia | Hyperaemia | RHI interpretation from boxplots: 1.9 [1.6–2.9] vs. 1.8 [2.0–3.3], p = 0.036. No effect of exercise |
| Prospective [29] | n = 21 | HT controls without HF (n = 19) Healthy controls (n = 10) |
endoPAT (RHI) | Ischemia | Hyperaemia | Log RHI: 0.85 ± 0.42 vs. 0.92 ± 0.38 vs. 1.33 ± 0.34, p = n.s. between HFpEF and HT controls |
| Skin-arm | ||||||
| Prospective [30] | n = 45 | HT controls, matched for age, sex and diabetic status (n = 45) | Laser Doppler flowmetry (LDF), power spectral density (PSD) of the LDF signal | None, ischemia | Vasomotion, hyperaemia | LDF PSD: lower in HFpEF, no absolute numbers reported, p < 0.05. Peak blood flow (PU): 135 [104–206] vs. 177 [139–216], p = 0.03 |
| Prospective [11] | HFpEF with CAD n = 12 | HFrEF with CAD (n = 12) CAD without HF (n = 12) |
Laser Doppler imaging (LDI) coupled with transcutaneous iontophoresis of vasodilators | acetylcholine, sodium nitroprusside | Hyperaemia | Vasodilation due to Acth: No absolute values reported. p = 0.00099 (HF vs. controls). Vasodilation due to nitroprusside: p = 0.006 (HF vs. controls) |
| Muscle-leg | ||||||
| Prospective [16] | n = 22 | Healthy controls, age-matched (n = 43). | Histology (skeletal muscle biopsy of thigh) | Capillary density | Capillary-to-fibre ratio: 1.35 ± 0.32 vs. 2.53 ± 1.37, p = 0.006 | |
| Prospective [31] | n = 7 | No controls. | Near-infrared spectroscopy: index for skeletal muscle haemoglobin oxygenation of thigh | Diffusion | Muscle deoxygenation overshoot was decreased after priming exercise, p = 0.041 | |
Abbreviations: CAD, coronary artery disease; CFR; coronary flow reserve; DM, diabetes mellitus; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; HT, hypertension; MVD, microvascular disease; RHI, Reactive hyperaemia index.