Abnormalities of endothelial function and endothelium-derived vasoactive substances may contribute to increased peripheral vasomotor tone during exercise in patients with congestive heart failure.
This review highlights the potential role of endothelial dysfunction and altered release of vasoactive substances in contributing to exercise intolerance in congestive heart failure.
The vascular endothelium releases vasoactive substances that appear to play an important role in the normal regulation of peripheral vasomotor tone. Nitric oxide, endothelins, prostaglandins, and other endothelium-derived vasodilating and vasoconstricting factors are released by the vascular endothelium in response to a diverse array of hormonal, pharmacologic, chemical, and physical stimuli. Shear stress, produced by pulsatile blood flow at the endothelial cell luminal surface, alters endothelial production of several endothelium-derived vasoactive substances, which may contribute to regional regulation of skeletal muscle blood flow during exercise. Abnormal vascular endothelium function has been shown in both experimental and clinical heart failure. Preliminary data suggest that abnormalities of endothelial function may contribute to increased peripheral vasomotor tone during exercise in patients with congestive heart failure.
Stuart D. Katz (Sat,) conducted a review in Congestive heart failure. Abnormalities of endothelial function and endothelium-derived vasoactive substances may contribute to increased peripheral vasomotor tone during exercise in patients with congestive heart failure.
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