Reduced peripheral arterial blood flow with preserved cardiac output during submaximal bicycle exercise in elderly heart failure
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Key result
During submaximal exercise, older patients with heart failure had significantly lower increases in superficial femoral arterial blood flow compared to healthy volunteers (79 vs 222 ml/min, p=0.002), despite preserved cardiac output.
Why the study?
Does submaximal bicycle exercise reveal reduced lower extremity blood flow independent of cardiac output in elderly heart failure patients compared to healthy volunteers?
Population
25 participants: 12 heart failure patients without large or medium sized vessel atherosclerosis, and 13 age…
Comparison
Submaximal bicycle exercise during… vs Age and gender matched healthy volunteers…
Design
Cross-sectional
Authors
Discussion
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Implication
Reduced LBF may limit daily activity tolerance in older HF; leaves open causality and therapeutic targets.
Study Design
Type
Cross-Sectional (n=25)
Blinding
Single-blind
Multicenter
No
Structured PICO
Does submaximal bicycle exercise reveal reduced lower extremity blood flow independent of cardiac output in elderly heart failure patients compared to healthy volunteers?
P
Population
25 older adults (12 with heart failure and 13 healthy volunteers) aged 57 to 82 years, free of peripheral atherosclerosis, underwent cardiovascular magnetic resonance during submaximal exercise.
E
Exposure
Submaximal bicycle exercise during cardiovascular magnetic resonance (CMR) assessment
C
Comparator
Age and gender matched healthy volunteers undergoing the same assessment
O
Outcome
Change in superficial femoral lower extremity blood flow (LBF) and aortic flow after submaximal exercisesurrogate
Main Result
Absolute Event Rate: 79% vs 222%
p-value: p=0.002
Elderly heart failure patients exhibit reduced lower extremity blood flow during submaximal exercise despite preserved cardiac output, suggesting peripheral rather than central mechanisms drive exercise intolerance.
Limitations
- Did not perform CMR blood flow measurements during maximal exercise
- Did not set an absolute workload for participants
- Cannot definitively exclude subclinical atherosclerosis
- Most participants were Caucasian
- Small sample size
- HF subjects held their HF medications the night before the study
Cite This Study
Puntawangkoon et al. (2009) conducted a cross-sectional in Heart failure (n=25). Heart failure vs. Healthy volunteers was evaluated on Change in superficial femoral arterial blood flow after submaximal exercise (p=0.002). During submaximal exercise, older patients with heart failure had significantly lower increases in superficial femoral arterial blood flow compared to healthy volunteers (79 vs 222 ml/min, p=0.002), despite preserved cardiac output.
Topics
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