Peripheral Cold Sensation in Patients with Chronic Heart Failure

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In patients with chronic heart failure (CHF), blood is redistributed to the major organs and blood perfusion of peripheral tissues decreases. Consequently, the skin temperature decreases, and patients experience a peripheral cold sensation (PCS). Blood reallocation involves autonomic nervous system control. In other words, a decrease in skin temperature and variation in autonomic nervous activity may be predictors of CHF severity. Forty-five patients with CHF were identified by New York Heart Association (NYHA) functional classification and divided into NYHA class I and NYHA class II-III groups. The temperature of the eardrum, toe, and skin were measured and the autonomic nervous activity was estimated by heart rate variability. We compared the results between the NYHA groups. The temperature of the left dorsum pedis and right pollex pedis were significantly lower in the NYHA class II-III group than in the NYHA I group. The difference in temperature between the eardrum and the left dorsum pedis and that between eardrum and right pollex pedis was significantly greater in the NYHA class II-III group than in the NYHA I group. However, there was no significant intergroup difference in autonomic nervous activity was noted. Body surface versus deep body temperature in patients with CHF were significantly lower in those with NYHA class II-III versus NYHA class I disease. Thus, PCS might be associated with CHF severity.