Heart failure & cardiomyopathiesCohort study
Comparison of Microcirculation in Chronic Heart Failure, Cardiogenic Shock, LVAD, and Heart Transplantation
- prospective study
Authors' conclusion
MCD is variably expressed across the spectrum of HF and its treatments, with particularly severe impairment in patients resuscitated from CS and postheart transplantation. These results suggest that restoration of macrohemodynamics does not equate to microvascular recovery and underscore the need for further investigation into the mechanisms, prognostic significance, and therapeutic targeting of systemic microvascular health in advanced cardiovascular disease.
Study context
- Population
- Adults with stable chronic heart failure (HF), cardiogenic shock (CS), HeartMate 3 (HM3) left ventricular assist device support, heart transplant (HT), and healthy controls (HCs), enrolled between August 2023 and December 2024patients, plus 44 HC · HF 120 · CS 81 · HM3 43 · HT 132 · HC 44
- Participants
- 376 adults
- Exposure
- Between-group differences in sublingual microcirculation across HF, CS, HM3, HT and HC
- HFn = 120
- CSn = 81
- HM3n = 43
- HTn = 132
- HCn = 44
- Outcome
- Between-group differences in vessel density, capillary blood volume, perfused boundary region, capillary blood flow and microvascular health score
Main finding
As reported in the abstract
Flow higher in HM3 than CS and HT
P = 0.039
CS and HT had lower capillary blood volume than HF
P < 0.01
Microvascular health score significantly lower in all patient cohorts compared to HC
all P < 0.01
HT showing lower microvascular health scores than HM3
P < 0.001
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Median age
- 62 years
- Females
- one-third
Original publication
Summarised from the published abstract; every number is checked against it