Circulation, Vol 54, 477-480, Copyright © 1976 by American Heart Association
J Longhurst, W Gifford and R Zelis
In this study, the effects of forearm static exercise were determined on
local blood flow and oxygen consumption in 15 normal individuals (NL) and
their responses were compared with ten patients in congestive heart failure
(CHF). Forearm blood flow was determined by a plethysmographic technique
before and during 15% of maximum voluntary contraction of the forearm.
Regional arterial and venous oxygen contents were sampled and forearm
oxygen consumption calculated by the Fick principle. At rest, forearm blood
flow was less in patients with heart failure than in normal individuals;
however, this was compensated for by an increased oxygen extraction, thus
maintaining forearm oxygen consumption at a normal level. In contrast,
during static exercise, forearm blood flow failed to rise normally with
heart failure (NL 9.31; CHF 4.35 ml/min-100 ml, P less than 0.001) and the
increased oxygen extraction was not sufficient to maintain a normal forearm
oxygen consumption (NL .82; CHF .44 ml/min-100 ml, P less than 0.01).
Therefore, patients with congestive heart failure demonstrate regional
circulatory and metabolic abnormalities during static exercise that are
comparable to those present during dynamic exercise. Because of a limited
ability of their skeletal muscle resistance vessels to respond to dilator
stimuli, they have an attenuation of their exercise hyperemia which leads
to an earlier shift to anaerobic metabolism.
ARTICLES
Impaired forearm oxygen consumption during static exercise in patients with congestive heart failure
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