Skin microcirculation and echocardiographic and biochemical indices of left ventricular dysfunction in non-diabetic patients with heart failure

Cardiol J. 2011;18(3):270-6.

Abstract

Background: We sought to noninvasively investigate skin microcirculation and to assess the relation between parameters of microcirculation and echocardiographic and biochemical parameters of left ventricular (LV) function in non-diabetic patients with heart failure (HF).

Methods and results: We measured skin microcirculation with laser Doppler flowmetry (LDF) at basal conditions (MFb), after warming to 44 degrees Centigrade (MF44) and after occlusion (AUC, PF%). Blood was sampled for NT-proBNP. We obtained information on patients' medical history and medication status. The mean (SD) age of 100 patients (43 women) was 68.2 ± 11.5 years. LV ejection fraction (LVEF) averaged 34.9 ± 13.3%, LV end-diastolic diameter (LVEDD) 6.0 ± 0.9 cm, NT-proBNP 4,582.6 ± 6,339.7 pg/mL. The parameters of microcirculation averaged: MFb 6.2 ± 4.7 perfusion units (PU), PF% 716.0 ± 437.8%, AUC 794 ± 706.1 PU/s, and MF44 77.9 ± 40.2 PU. NT-proBNP correlated negatively with LVEF (p ≤ 0.0001) and positively with LVEDD (p = 0.003). MFb was positively correlated with LVEF (r = 0.24, p = 0.03), and MF44 was negatively correlated with LVEDD (r = 0.22, p = 0.02). The relations remained significant after adjustments for sex, age, and use of medication. We observed no relation between NT-proBNP and microcirculatory derangement.

Conclusions: LDF-derived parameters of skin microcirculation are related to echocardiographic, but not biochemical, indices of HF.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Biomarkers / blood
  • Echocardiography
  • Female
  • Heart Failure / diagnostic imaging*
  • Heart Failure / drug therapy
  • Heart Failure / physiopathology*
  • Humans
  • Laser-Doppler Flowmetry
  • Male
  • Microcirculation / drug effects
  • Microcirculation / physiology*
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Skin / blood supply*
  • Stroke Volume / physiology
  • Vascular Diseases / metabolism
  • Vascular Diseases / physiopathology
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / physiopathology*

Substances

  • Adrenergic beta-Antagonists
  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain