Physical exercise improves the peripheral microcirculation of patients with chronic heart failure.
OBJECTIVE
Patients with chronic heart failure (CHF) present with microcirculation alterations, partially attributed to endothelial dysfunction. Exercise training has been shown to induce beneficial effects in CHF patients. The aim of our study was to assess the effect of physical exercise on the microcirculation of CHF patients by near-infrared spectroscopy (NIRS).


METHODS
Sixteen consecutive stable CHF patients (men, n = 10; mean age = 50 +/- 12 years) participated in a 3-month rehabilitation program (3 sessions per week). All patients performed symptom-limited, ramp-incremental cardiopulmonary exercise testing on a cycle ergometer before and after the completion of the program. Measurements included peak oxygen uptake (VO2peak), VO2 at anaerobic threshold (AT), and first-degree slope of VO2 during the first minute of recovery (VO2/t slope). Tissue oxygen saturation was continuously measured by NIRS at the thenar muscle during a 3-minute vascular occlusion with a pneumatic cuff (occlusion technique) before and after the rehabilitation program.


RESULTS
The oxygen reperfusion rate (%/min) following the release of vascular occlusion increased significantly after the rehabilitation program (450 +/- 105 to 532 +/- 151, P = .004) as did vascular reactivity (from 27 +/- 13%/min to 39 +/- 21%/min, P = .006). In addition, there was a significant increase in VO2peak and AT (from 14.3 +/- 4.7 mL . kg . min to 16.7 +/- 6.3 mL . kg . min and from 9.5 +/- 3.6 mL . kg . min to 11.3 +/- 4 mL . kg . min, P = .007 and P = .012, respectively) as well as in VO2/t slope (from 0.35 +/- 0.17 to 0.51 +/- 0.07 mL . kg . min, P = .005).


CONCLUSIONS
Peripheral microcirculation of CHF patients measured by NIRS improved after the rehabilitation program. NIRS is a noninvasive technique that could be used to evaluate the effect of rehabilitation on the peripheral microcirculation of CHF patients.
Gerovasili
Vasiliki
V
Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Pulmonary & Critical Care Medicine Department, Evgenidio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Drakos
Stavros
S
Kravari
Maria
M
Malliaras
Konstantinos
K
Karatzanos
Eleftherios
E
Dimopoulos
Stavros
S
Tasoulis
Athanasios
A
Anastasiou-Nana
Maria
M
Roussos
Charis
C
Nanas
Serafim
S
D002908:Chronic Disease; D004730:Endothelium, Vascular / Q000503:physiopathology*; D016552:Ergometry; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply*; D010101:Oxygen Consumption; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D019265:Spectroscopy, Near-Infrared; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires