Skin microcirculation in patients with heart failure with different left ventricular systolic dysfunction

Abstract

Aim. To study the relationship of mechanisms of microcirculation regulation and intracardiac hemodynamics in patients with heart failure (HF).Material and methods. In eighty patients with NYHA class II-IV HF, microcirculation was assessed by laser Doppler flowmetry and intracardiac hemodynamics — by echocardiography.Results. The patients were divided into 3 groups depending on HF type: with preserved ejection fraction (CHpEF) (>50%) — 27 patients, mid-range EF (CHmrEF) (40-50%) — 25 patients, reduced EF (CHrEF) (<40%) — 28 patients. Comparative analysis revealed a significant decrease in the coefficient of variation (CV) in all groups without microcirculation differences. The greatest number of significant correlations was found between the myogenic component of microcirculation frequency range and the following echocardiographic parameters: left ventricular EF (r=0,351, p<0,05); end-diastolic dimension (r=-0,492, p<0,05), end-systolic dimension (r=-0,474, p<0,05), end-diastolic volume (r=-0,544, p<0,05), end-systolic volume (r=-0,449, p<0,05), etc.Conclusion. In patients, regardless of left ventricular EF, satisfactory perfusion was obtained, which is achieved due to inhibition of active mechanisms and compensatory activation of passive mechanisms of microcirculation regulation. The relationship between the development of myocardial remodeling and microcirculatory dysfunction is noted.

Keywords

• heart failure
• clinical and morphological patterns
• microcirculation
• laser doppler flowmetry