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Effects of heat stress on thermoregulatory responses in congestive heart failure patients.
Circulation. 2005 Oct 11; 112(15):2286-92.Circ

Abstract

BACKGROUND

Clinical observations suggest that tolerance to heat stress may be impaired in patients with cardiovascular diseases, particularly those associated with impaired ventricular function and congestive heart failure (CHF). However, thermoregulatory function during a controlled heat stress challenge in patients with CHF has not been studied.

METHODS AND RESULTS

To test the hypothesis that thermoregulatory responses are attenuated in such patients, we assessed cutaneous vasodilation and sweat rate in patients with stable class II-III CHF and in matched healthy subjects during passive whole-body heating. Whole-body heating induced a similar increase in internal temperature (approximately 0.85 degrees C) in both groups. The sweating responses in patients with CHF were not significantly different from that in control subjects. In contrast, the elevation in forearm cutaneous vascular conductance in patients with CHF was reduced by nearly 50% relative to the control subjects (3.8+/-0.8 versus 6.9+/-1.0 mL/100 mL tissue per minute per 100 mm Hg, P=0.04). Moreover, maximal cutaneous vasodilator capacity to direct local heating in patients with CHF was also significantly lower than in control subjects, suggesting that vascular remodeling may be limiting cutaneous vasodilation during hyperthermia.

CONCLUSIONS

These observations suggest that patients with CHF exhibit attenuated cutaneous vasodilator responses to both whole-body and local heating, whereas sweating responses are preserved. Attenuated cutaneous vasodilation may be a potential mechanism for heat intolerance in patients with CHF.

Authors+Show Affiliations

Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, Dallas, TX 75231, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16216975

Citation

Cui, Jian, et al. "Effects of Heat Stress On Thermoregulatory Responses in Congestive Heart Failure Patients." Circulation, vol. 112, no. 15, 2005, pp. 2286-92.
Cui J, Arbab-Zadeh A, Prasad A, et al. Effects of heat stress on thermoregulatory responses in congestive heart failure patients. Circulation. 2005;112(15):2286-92.
Cui, J., Arbab-Zadeh, A., Prasad, A., Durand, S., Levine, B. D., & Crandall, C. G. (2005). Effects of heat stress on thermoregulatory responses in congestive heart failure patients. Circulation, 112(15), 2286-92.
Cui J, et al. Effects of Heat Stress On Thermoregulatory Responses in Congestive Heart Failure Patients. Circulation. 2005 Oct 11;112(15):2286-92. PubMed PMID: 16216975.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of heat stress on thermoregulatory responses in congestive heart failure patients. AU - Cui,Jian, AU - Arbab-Zadeh,Armin, AU - Prasad,Anand, AU - Durand,Sylvain, AU - Levine,Benjamin D, AU - Crandall,Craig G, PY - 2005/10/12/pubmed PY - 2006/3/3/medline PY - 2005/10/12/entrez SP - 2286 EP - 92 JF - Circulation JO - Circulation VL - 112 IS - 15 N2 - BACKGROUND: Clinical observations suggest that tolerance to heat stress may be impaired in patients with cardiovascular diseases, particularly those associated with impaired ventricular function and congestive heart failure (CHF). However, thermoregulatory function during a controlled heat stress challenge in patients with CHF has not been studied. METHODS AND RESULTS: To test the hypothesis that thermoregulatory responses are attenuated in such patients, we assessed cutaneous vasodilation and sweat rate in patients with stable class II-III CHF and in matched healthy subjects during passive whole-body heating. Whole-body heating induced a similar increase in internal temperature (approximately 0.85 degrees C) in both groups. The sweating responses in patients with CHF were not significantly different from that in control subjects. In contrast, the elevation in forearm cutaneous vascular conductance in patients with CHF was reduced by nearly 50% relative to the control subjects (3.8+/-0.8 versus 6.9+/-1.0 mL/100 mL tissue per minute per 100 mm Hg, P=0.04). Moreover, maximal cutaneous vasodilator capacity to direct local heating in patients with CHF was also significantly lower than in control subjects, suggesting that vascular remodeling may be limiting cutaneous vasodilation during hyperthermia. CONCLUSIONS: These observations suggest that patients with CHF exhibit attenuated cutaneous vasodilator responses to both whole-body and local heating, whereas sweating responses are preserved. Attenuated cutaneous vasodilation may be a potential mechanism for heat intolerance in patients with CHF. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16216975/Effects_of_heat_stress_on_thermoregulatory_responses_in_congestive_heart_failure_patients_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.105.540773?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -