title: Attenuated Microcirculatory Response to Maximal Exercise in Patients With Chronic Heart Failure.
abstract: OBJECTIVE
  Exercise training programs improve microcirculatory alternations in patients with chronic heart failure (CHF). However less is known about the acute effect of maximum exercise on the skeletal muscle microcirculation. We aimed to assess the effect of acute exercise on peripheral microcirculation of patients with CHF, as assessed by near-infrared spectroscopy with vascular occlusion technique.
  
  
  METHODS
  Tissue oxygenation was evaluated in 8 stable patients with CHF (7 males; mean age, 60 ± 9 years; body mass index, 26.3 ± 3.8 kg/m) and 8 healthy subjects (matched for age, sex, and body mass index) before and after cardiopulmonary exercise testing. Tissue oxygen saturation (StO2), StO2peak, oxygen consumption rate, and endothelial function (reperfusion rate), before and after maximum exercise, were assessed.
  
  
  RESULTS
  Patients with CHF had lower StO2 and reperfusion rate compared with healthy subjects (71.4% ± 9.8% vs 81.0% ± 5.4% and 9 ± 1 %/min vs 13.9 ± 5.8%/min, respectively; P < .05) at rest. Oxygen consumption rate increased after exercise in patients with CHF and healthy subjects (from -31.7 ± 8.2 to -43.7 ± 12.7 and from -35.7 ± 6.7 to -42.4 ± 6.4, respectively; P < .05). StO2 decreased significantly after maximal exercise in patients with CHF (from 71.4 ± 9.8 to 65.2 ± 12.7; P < .05), whereas it returned to the preexercise values in healthy subjects (from 81.0 ± 5.4 to 80.3 ± 7.0). There was a significant between-group difference (P < .05).
  
  
  CONCLUSIONS
  Patients with CHF present microcirculatory alternations. Acute exercise exerts an effect on microcirculation in peripheral, nonexercising muscles, with altered response in patients with CHF compared with healthy subjects.
authors.affiliation: 1st Critical Care Medicine Department (Drs Tzanis, Manetos, Dimopoulos, Vasileiadis, Karatzanos, and Nanas), Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidion Hospital, NKUA, Athens, Greece; and 3rd Cardiology Department (Drs Malliaras and Kaldara), NKUA, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tzanis
authors.forename: Christos
authors.initials: C
authors.lastname: Manetos
authors.forename: Stavros
authors.initials: S
authors.lastname: Dimopoulos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vasileiadis
authors.forename: Kostas
authors.initials: K
authors.lastname: Malliaras
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kaldara
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Karatzanos
authors.forename: Serafim
authors.initials: S
authors.lastname: Nanas
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D004730:Endothelium, Vascular / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D005082:Physical Exertion / Q000502:physiology*; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen