THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION

Aim. To study the combination and contribution of risk factors (age, hypertension (HT), obesity, diabetes mellitus, chronic kidney disease (CKD), length of illness) leading to the formation of chronic heart failure (CHF) with preserved ejection fraction (EF).Material and methods. The study included...

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Main Authors: M. V. Kurkina, A. G. Avtandilov, I. A. Krutovcev
Format: Article
Language:English
Published: Столичная издательская компания 2017-11-01
Series:Рациональная фармакотерапия в кардиологии
Subjects:
Online Access:https://www.rpcardio.online/jour/article/view/1529
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author M. V. Kurkina
A. G. Avtandilov
I. A. Krutovcev
author_facet M. V. Kurkina
A. G. Avtandilov
I. A. Krutovcev
author_sort M. V. Kurkina
collection DOAJ
description Aim. To study the combination and contribution of risk factors (age, hypertension (HT), obesity, diabetes mellitus, chronic kidney disease (CKD), length of illness) leading to the formation of chronic heart failure (CHF) with preserved ejection fraction (EF).Material and methods. The study included 100 hypertensive patients (aged 40 to 80 years) with concomitant obesity or diabetes or CKD. Patients were divided into 4 groups depending on the presence of one major and/or several concomitant diseases. Echocardiography, assessment of large arterial vessels stiffness indices (SI m/s, CAVI m/s), and determination of small muscle arteries tonus (RI%) were performed in all patients.Results. Remodeling of the left ventricle (LV) and left atrial (LA) was observed in all patients with comorbid status, as well as reduction in diastolic function. The LV myocardial mass index in the first group was 117.2±31.4 g/m2, in the second one – 125.9±27.4 g/m2, in the third group – 121.5±15.6 g/m2 and in the fourth one – 126.1±11.5 g/m2. A significant increase in the LA volume index was founded in the first group  – 33.4±3.9 ml/m2, in the second one – 39.6±9.1 ml/m2, in the third group – 38.1±5.2 ml/m2 and in the fourth one – 39.8±6.6 ml/m2 (р<0.05). The parameters reflecting the rigidity of large arterial vessels (SI m/s, CAVI m/s) also exceeded the threshold values in each group; significant differences SI were between the first and fourth, second  and fourth groups  (р<0.05), CAVI between the first and third groups  (р<0.05). A significant correlation was found between CAVI and age (r=0.63), which indicated an increase in arterial stiffness with age.Conclusions. In the formation of CHF with preserved EF, additional factors enhance the changes associated with LV remodeling and LA overload. These changes occur with a progressive decrease in LV diastolic function and increase in myocardial stiffness. HT and obesity are the main contributors to the development of CHF with preserved EF. Remodeling of the LV, LA and vascular system in CHF with preserved EF develop simultaneously.
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spelling doaj.art-790cf25aad5a41628f6f5d5782570a622024-04-01T07:43:35ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532017-11-0113561562110.20996/1819-6446-2017-13-5-615-6211384THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTIONM. V. Kurkina0A. G. Avtandilov1I. A. Krutovcev2Russian Medical Academy of Continuing Vocational EducationRussian Medical Academy of Continuing Vocational EducationRussian Medical Academy of Continuing Vocational EducationAim. To study the combination and contribution of risk factors (age, hypertension (HT), obesity, diabetes mellitus, chronic kidney disease (CKD), length of illness) leading to the formation of chronic heart failure (CHF) with preserved ejection fraction (EF).Material and methods. The study included 100 hypertensive patients (aged 40 to 80 years) with concomitant obesity or diabetes or CKD. Patients were divided into 4 groups depending on the presence of one major and/or several concomitant diseases. Echocardiography, assessment of large arterial vessels stiffness indices (SI m/s, CAVI m/s), and determination of small muscle arteries tonus (RI%) were performed in all patients.Results. Remodeling of the left ventricle (LV) and left atrial (LA) was observed in all patients with comorbid status, as well as reduction in diastolic function. The LV myocardial mass index in the first group was 117.2±31.4 g/m2, in the second one – 125.9±27.4 g/m2, in the third group – 121.5±15.6 g/m2 and in the fourth one – 126.1±11.5 g/m2. A significant increase in the LA volume index was founded in the first group  – 33.4±3.9 ml/m2, in the second one – 39.6±9.1 ml/m2, in the third group – 38.1±5.2 ml/m2 and in the fourth one – 39.8±6.6 ml/m2 (р<0.05). The parameters reflecting the rigidity of large arterial vessels (SI m/s, CAVI m/s) also exceeded the threshold values in each group; significant differences SI were between the first and fourth, second  and fourth groups  (р<0.05), CAVI between the first and third groups  (р<0.05). A significant correlation was found between CAVI and age (r=0.63), which indicated an increase in arterial stiffness with age.Conclusions. In the formation of CHF with preserved EF, additional factors enhance the changes associated with LV remodeling and LA overload. These changes occur with a progressive decrease in LV diastolic function and increase in myocardial stiffness. HT and obesity are the main contributors to the development of CHF with preserved EF. Remodeling of the LV, LA and vascular system in CHF with preserved EF develop simultaneously.https://www.rpcardio.online/jour/article/view/1529left ventricular remodelingstiffness vesselscomorbid statesdiastolic dysfunction
spellingShingle M. V. Kurkina
A. G. Avtandilov
I. A. Krutovcev
THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
Рациональная фармакотерапия в кардиологии
left ventricular remodeling
stiffness vessels
comorbid states
diastolic dysfunction
title THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
title_full THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
title_fullStr THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
title_full_unstemmed THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
title_short THE ROLE OF FACTORS AFFECTING THE FORMATION OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
title_sort role of factors affecting the formation of chronic heart failure with preserved ejection fraction
topic left ventricular remodeling
stiffness vessels
comorbid states
diastolic dysfunction
url https://www.rpcardio.online/jour/article/view/1529
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