Features of diagnostics and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Experts in Heart Failure, Russian Association of Gerontologists, and Euroasian Association of Therapists

Орлова, Я.А.; Ткачева, О. Н.; Arutyunov, G. P.; Kotovskaya, Yu. V.; Lopatin, Yuri; Mareev, V Yu; Mareev, Yu V; Runihina, N K; Скворцов, А. А.; Стражеско, И. Д.; Фролова, Е В

doi:10.18087/cardio.2560

Cited by 24 publications

(11 citation statements)

References 170 publications

(174 reference statements)

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“…С увеличением возраста увеличивается число больных с ХСН. В связи с этим был подготовлен и опубликован документ, отражающий согласованное мнение экспертов «Особенности диагностики и лечения хронической сердечной недостаточности у пациентов пожилого и старческого возраста» [27].…”

Section: сердечная недостаточность в пожилом и старческом возрастеunclassified

“…Лечащий врач должен регулярно проверять весь перечень ЛС, которые принимает пожилой пациент. При обнаружении любого нового симптома у пожилого пациента нужно исключать возможность нежелательных лекарственных реакций применяемых средств [27].…”

Section: сердечная недостаточность в пожилом и старческом возрастеunclassified

“…При этом одним из первых и ключевых исследований по оценке эффективности терапии БРА стала программа CHARM. Так, в исследовании CHARM Alternative представитель группы сартанов кандесартан у пациентов с фракцией выброса левого желудочка (ФВ ЛЖ) менее 40 % и не переносящих ингибиторы АПФ продемонстрировал достоверное снижение относительного [27]. И важно, что только для кандесартана было показано снижение функционального класса по NYHA для пациентов с СН и сохраненной ФВ [31,32].…”

Section: сердечная недостаточность в пожилом и старческом возрастеunclassified

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Gerontology Issues in Cardiology Practice

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Increase in life expectancy during the second part of the 20th century is accompanied by increase in proportion of elderly and senile age population. However, despite the increase in life expectancy, the prevalence of most chronic diseases and functional impairments rises with age. Elderly and senile age is associated with the risk of cardiovascular diseases (CVD), therefore the problem of managing elderly patients with CVD becomes especially urgent.

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Section: сердечная недостаточность в пожилом и старческом возрастеunclassified

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“…Успехи в лечении заболеваний, являющихся этиологией ХСН, привели к росту распространенности их в популяции и формированию феномена коморбидного больного, у которого наравне с ХСН присутствуют и артериальная гипертония (АГ), ишемическая болезнь сердца (ИБС), фибрилляция предсердий (ФП) и прочие состояния [5,6]. Вышеперечисленные тенденции способствуют изменению клинического течения ХСН у современных больных [7,8] и требуют создания специальных условий оказания медицинской помощи для данной категории пациентов.…”

Section: Introductionunclassified

“…В последние годы все чаще зарубежные и российские эксперты в области ХСН высказывают мнение о необходимости изменения подходов к ведению пациентов с ХСН и создании центров специализированной медицинской помощи [7,9,10,11]. Особую важность имеет изменение подходов к курации больных ХСН, перенесших острую декомпенсацию сердечной недостаточности (ОДСН), так как это «уязвимая» категория пациентов с высоким риском летальности и повторных госпитализаций [9].…”

Section: Introductionunclassified

Rationale of specialized medical care for patients with chronic heart failure in the Russian Federation

Фомин

Vinogradova

2020

jour

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Objectives: to determine the causes of ineffective observation and poor prognosis in patients undergoing ADHF, in real clinical practice and to consider the basics of the formation of specialized medical care for patients with heart failure (HF).Materials and methods: the study was conducted based on the City Center for the treatment of heart failure (center HF), N. Novgorod. The study consistently included 942 patients with heart failure (HF) at the age of 18 years and older who underwent ADHF and received inpatient treatment in center HF between March 4, 2016 and March 3, 2017. Based on the decisions of patients to continue outpatient monitoring in center HF, two groups of patients were distinguished: patients who continued to be monitored in center HF (group I, n = 510) and patients who continued to be monitored in outpatient clinics at the place of residence (group II, n = 432). The assessment of adherence to treatment, overall mortality, survival and re-admission to a depth of two years of observation was carried out. Statistical data processing was performed using Statistica 7.0 for Windows and the software package R.Results: all patients in the study groups had high comorbidity. Group 2 patients turned out to be statistically significantly older, more often had III functional class (FC) HF, lower the baseline test score of 6-minute walk, and higher the baseline clinical assessment scale. After 2 years of follow-up in group II, there was a significant deterioration in adherence to basic therapy of HF compared with group I. According to the results of multifactorial proportional risk Cox models, it was shown that observation of patients in the group 1 is an independent factor increasing the risk of overall mortality by 2.8 times by the end of the second year of observation. Survival after two years of follow-up was: in group I — 89.8 %, and in group II — 70.1 % of patients (OR = 0.3, 95 % CI 0.2 – 0.4; p1/2 < 0.001). After two years of follow-up, the proportion of re-hospitalized patients in group II was greater (78.0 % of patients) versus group 1 (50.6 % of patients, OR = 3.5, 95 % CI 2.6 – 4.6; p1/2 <0.001). The independent risk of re-hospitalization according to multinominal logit regression was 3.4 times higher in group II and 2.4 times for III – IV FC HF. Conclusions: the inclusion of patients with HF in the system of specialized medical care improves adherence to treatment, prognosis of life and reduces the risk of repeated hospitalizations. Patients of an older age and with an initially greater clinical severity refused specialized supervision in center HF.

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Levels of Serum IGF-1, HCY, and Plasma BNP in Patients with Chronic Congestive Heart Failure and Their Relationship with Cardiac Function and Short-Term Prognosis

Mao

Wang

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the levels of serum insulin like growth factor-1 (IGF-1), homocysteine (HCY), and plasma brain natriuretic peptide (BNP) in patients with chronic congestive heart failure (CCHF) and their relationship with cardiac function and short-term prognosis. Methods. A total of 95 patients with CCHF admitted to our hospital from October 2017 to December 2018 were selected as the observation group. Patients conform to grade II∼IV of the New York Heart Association (NYHA) heart function class. At the same time, the people with normal physical examination results were selected as a control group. Serum IGF-1, HCY, and plasma BNP levels were detected in the two groups, and left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were detected in the observation group. According to the follow-up results, the observation group was divided into the subgroup with good prognosis and the subgroup with poor prognosis. The relationship between the levels of serum IGF-1, HCY, and plasma BNP among cardiac function and short-term prognosis were analyzed. Results. The serum IGF-1 level of the observation group was lower than that of the control group, and the serum HCY and plasma BNP levels were higher than those of the control group ( P < 0.05 ). Serum IGF-1 level in grade III of NYHA was lower than that in grade II, and serum HCY and plasma BNP levels were higher than those in grade II. Serum IGF-1 level in grade IV was lower than that in grade II and grade III, and serum HCY and plasma BNP levels were higher than those in grade II and grade III ( P < 0.05 ). Serum IGF-1 level was negatively correlated with LVDd and positively correlated with LVEF. Serum HCY and plasma BNP levels were positively correlated with LVDd and negatively correlated with LVEF ( P < 0.05 ). There were 42 patients with poor prognoses (44.21%). Serum IGF-1 levels of patients with poor prognosis were lower than those with good prognosis, and serum HCY and plasma BNP levels were higher than those with good prognosis ( P < 0.05 ). Conclusion. The serum IGF-1 level in patients with CCHF decreased, and serum HCY and plasma BNP levels increased. Serum IGF-1, HCY, and plasma BNP were correlated with cardiac function and have some clinical value for short-term prognosis.

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Features of diagnostics and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Experts in Heart Failure, Russian Association of Gerontologists, and Euroasian Association of Therapists

Abstract: .

Cited by 24 publications

References 170 publications

Gerontology Issues in Cardiology Practice

Gerontology Issues in Cardiology Practice

Rationale of specialized medical care for patients with chronic heart failure in the Russian Federation

Levels of Serum IGF-1, HCY, and Plasma BNP in Patients with Chronic Congestive Heart Failure and Their Relationship with Cardiac Function and Short-Term Prognosis

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