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Service de Cardiologie et de Pharmacologie Clinique, Association Claude BernardCentre de Recherches Cardiologiques, Département de Biostatistiques et d'Informatique, Hôpital Pitié-Salpêtrière, and Institut Terrapharm 75013 Paris, France
Received 15 April 1996; accepted in final form 2 August 1996.
Isnard, Richard, Philippe Lechat, Hanna Kalotka, Hafida
Chikr, Serge Fitoussi, Joseph Salloum, Jean-Louis Golmard, Daniel Thomas, and Michel Komajda. Muscular blood flow response to submaximal leg exercise in normal subjects and in patients with heart
failure. J. Appl. Physiol. 81(6):
2571-2579, 1996.
Blood flow to working skeletal muscle is usually
reduced during exercise in patients with congestive heart failure. An
intrinsic impairment of skeletal muscle vasodilatory capacity has been
suspected as a mechanism of this muscle underperfusion during maximal
exercise, but its role during submaximal exercise remains unclear.
Therefore, we studied by transcutaneous Doppler ultrasonography the
arterial blood flow in the common femoral artery at rest and during a
submaximal bicycle exercise in 12 normal subjects and in 30 patients
with heart failure. Leg blood flow was lower in patients
than in control subjects at rest [0.29 ± 0.14 (SD) vs. 0.45 ± 0.14 l/min, P < 0.01], at absolute powers and at the same relative power (2.17 ± 1.06 vs. 4.39 ± 1.4 l/min, P < 0.001). Because mean arterial pressure was maintained, leg vascular
resistance was higher in patients than in control subjects at rest (407 ± 187 vs. 247 ± 71 mmHg · l
1 · min,
P < 0.01) and at the
same relative power (73 ± 49 vs. 31 ± 13 mmHg · l1 · min,
P < 0.01) but not at absolute
powers. Although the magnitude of increase in leg blood flow corrected
for power was similar in both groups (31 ± 10 vs. 34 ± 10 ml · min1 · W1),
the magnitude of decrease of leg vascular resistance corrected for
power was higher in patients than in control subjects (5.9 ± 3.3 vs. 1.9 ± 0.94 mmHg · l1 · min · W1,
P < 0.001). These results suggest
that the ability of skeletal muscle vascular resistance to decrease is
not impaired and that intrinsic vascular abnormalities do not limit
vasodilator response to submaximal exercise in patients with heart
failure.
congestive heart failure; vasodilation; oxygen consumption; Doppler ultrasonography
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