Low-frequency blood flow oscillations in congestive heart failure and after β1-blockade treatment

Laser Doppler flowmetry (LDF) of forearm skin blood flow, combined with iontophoretically-administered acetylcholine and sodium nitroprusside and wavelet spectral analysis, was used for noninvasive evaluation of endothelial function in 17 patients newly diagnosed with New York Heart Association class II-III congestive heart failure (CHF). After 20 ± 10 weeks' treatment with a β1-blocker (Bisoprolol), the measurements were repeated. Measurements were also made on an age- and sex-matched group of healthy controls (HC). In each case data were recorded for 30 min. In HC, the difference in absolute spectral amplitude of LDF oscillations between the two vasodilators manifests in the frequency interval 0.005-0.0095 Hz (p < 0.01); this difference is initially absent in patients with CHF, but appears following the β1-blocker treatment (p < 0.01). For HC, the difference between the two vasodilators also manifests in normalised spectral amplitude in 0.0095-0.021 Hz (p < 0.05). This latter difference is absent in CHF patients and is unchanged by treatment with β1-blockers. It is concluded that there are two oscillatory skin blood flow components associated with endothelial function. Both are reduced in CHF. Activity in the lower frequency interval is restored by β1-blocker treatment, confirming the association between CHF and endothelial dysfunction but suggesting the involvement of two distinct mechanisms.