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Regulation of extremity (limb) circulation was studied in 21 patients suffering from congestive heart failure. In 11 cases the peripheral circulation was intact, while 10 patients also suffered from peripheral obliterative arterial disease. Data of 75 patients with normal cardiac condition served as control: 35 subjects with intact peripheral circulation and 40 patients suffering from peripheral obliterative arterial disease. Limb blood flow was measured by using venous isotope dilution technique. Cardiac output was determined by the dye dilution method. In chronic heart failure the limb circulation characteristically deviated from the normal; the limb blood flow and the limb oxygen consumption slightly decreased, while the limb vascular resistance markedly increased. The diminution of the limb blood flow and the increase in the limb vascular resistance due to obliterative arterial disease were more pronounced in patients suffering from congestive heart failure. The pathological increase in the peripheral vascular resistance due to chronic heart failure proved mostly reversible; on the administration of vasodilator drugs the elevated limb vascular resistance markedly decreased and the limb blood flow significantly increased.

The regulation of the peripheral-limb circulation was investigated in 21 patients suffering from chronic cardiac failure (NYHA stage II and III). In 11 patients the extremital circulation was intact, while 10 patients suffered from peripheral obliterative arterial disease, too (intermittent claudication or rest pain). The control group consisted of 75 subjects with normal cardiac condition. In 35 of the control subjects the peripheral circulation was intact, the remaining 40 suffered from extremital venous isotope dilution technique. In congestive heart failure the limb blood flow and the limb oxygen consumption slightly diminished, but remained in the normal range. The limb vascular resistance significantly increased. In patients suffering from intermittent claudication or rest pain, the marked diminution of the limb blood flow and elevation of the vascular resistance was more pronounced in congestive heart failure than in healthy subjects. The pathologically elevated limb vascular resistance decreased and the limb blood flow significantly increased in congestive heart failure on administration of vasodilator drugs. A pathological and mostly reversible increase in extremital vascular resistance is the most characteristic sign of the peripheral circulation in congestive heart failure.