Peripheral Muscle Microcirculation Dynamics During Strength Exercise in Heart Failure Patients: A Cross-Sectional Study
Abstract This cross-sectional study aimed to compare the muscle microcirculation dynamics via near-infrared spectroscopy (NIRS) response during an isokinetic muscle strength test and ultrasound-derived parameters in heart failure patients with preserved or reduced ejection fraction phenotypes (HFpEF and HFrEF, respectively) and different functional severities (Weber Class A, B, and C). Twenty-eight aged-matched patients with HFpEF (n = 16) and HFrEF (n = 12) were assessed. Within HFpEF, Weber Class C patients presented a worse capability to reach a greater oxygen extraction during exercise than Classes A and B. Among those with Weber C severity, while HFrEF patients reached lower oxyhemoglobin (O2Hb, µM) (-10.9 ± 3.8 vs. -23.7 ± 5.7, p = 0.029) during exercise, HFpEF kept a lower O2Hb during the recovery period (-3.0 ± 3.4 vs. 5.9 ± 2.8, p = 0.007). Among the ultrasound-derived variables, HFpEF, Weber Class C, also presented a higher echo intensity than HFrEF patients (29.7 ± 8.4 vs. 15.1 ± 6.8, p = 0.017). Our study reveals more pronounced impairments in local microcirculatory dynamics in HFpEF vs. HFrEF patients during muscle strength exercise, combined with muscle-skeletal abnormalities detected via ultrasound imaging, which may help to explain the commonly observed exercise intolerance in HFpEF patients.