Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Nanas S, Gerovasili V, Dimopoulos S, Pierrakos C, Kourtidou S, Kaldara E, Sarafoglou S, Venetsanakos J, Roussos C, Nanas J, Anastasiou-Nana M. J Card Fail. 2008;14(5):400-406.
Background: Skeletal muscle microcirculation impairment in patients with chronic heart failure (CHF) seems to correlate with disease severity. We evaluated the microcirculation by near-infrared spectroscopy (NIRS) occlusion technique before and after inotropic infusion.
Methods: We evaluated 25 patients with stable CHF, 30 patients with end-stage CHF (ESCHF) receiving treatment with intermittent infusion of inotropic agents, and 12 healthy subjects. Thenar muscle tissue oxygen saturation (StO2%) was measured noninvasively by NIRS before, during, and after 3-minute occlusion of the brachial artery (occlusion technique) in all subjects and in patients with ESCHF before and after 6 hours of inotropic infusion (dobutamine and/or levosimendan) or placebo (N = 5).
Results: Patients with ESCHF or CHF presented significantly lower StO2% than healthy subjects (74.5% ± 7%, 78.6% ± 6%, and 85% ± 5%, respectively; P = .0001), lower oxygen consumption rate during occlusion (24.6% ± 8%/min, 28.6% ± 10%/min, and 38.1% ± 11.1%/min, respectively; P = .001), and lower reperfusion rate (327% ± 141%/min, 410% ± 106%/min, and 480% ± 133%/min, respectively; P = .002). After 6 hours of inotropic infusion, patients with ESCHF showed significantly increased StO2% (74.5% ± 7% to 82% ± 9%, P = .001), oxygen consumption rate (24.6% ± 8%/min to 29.3% ± 8%/min, P = .009), and reperfusion rate (327% ± 141%/min to 467% ± 151%/min, P = .001). No statistical difference was noted in the placebo group.
Conclusion: Peripheral muscle microcirculation as assessed by NIRS is impaired in patients with CHF. This impairment is partially reversed by infusion of inotropic agents in patients with ESCHF.