Skin microcirculation and echocardiographic and biochemical indices of left ventricular dysfunction in non-diabetic patients with heart failure.

BACKGROUND We sought to noninvasively investigate skin microcirculation and to assess the relation between parameters of microcirculation and echocardiographic and biochemical parameters of left ventricular (LV) function in non-diabetic patients with heart failure (HF). METHODS AND RESULTS We measured skin microcirculation with laser Doppler flowmetry (LDF) at basal conditions (MFb), after warming to 44 degrees Centigrade (MF44) and after occlusion (AUC, PF%). Blood was sampled for NT-proBNP. We obtained information on patients' medical history and medication status. The mean (SD) age of 100 patients (43 women) was 68.2 ± 11.5 years. LV ejection fraction (LVEF) averaged 34.9 ± 13.3%, LV end-diastolic diameter (LVEDD) 6.0 ± 0.9 cm, NT-proBNP 4,582.6 ± 6,339.7 pg/mL. The parameters of microcirculation averaged: MFb 6.2 ± 4.7 perfusion units (PU), PF% 716.0 ± 437.8%, AUC 794 ± 706.1 PU/s, and MF44 77.9 ± 40.2 PU. NT-proBNP correlated negatively with LVEF (p ≤ 0.0001) and positively with LVEDD (p = 0.003). MFb was positively correlated with LVEF (r = 0.24, p = 0.03), and MF44 was negatively correlated with LVEDD (r = 0.22, p = 0.02). The relations remained significant after adjustments for sex, age, and use of medication. We observed no relation between NT-proBNP and microcirculatory derangement. CONCLUSIONS LDF-derived parameters of skin microcirculation are related to echocardiographic, but not biochemical, indices of HF.