Novel algorithms for diagnosing heart failure with preserved ejection fraction in patients with hypertension and obesity

Васюк, Ю. А.; Шупенина, Е. Ю.; Намазова, Г. А.; Дубровская, Т. И.

doi:10.15829/1728-8800-2021-2569

Cited by 4 publications

(1 citation statement)

References 33 publications

(31 reference statements)

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“…Факторами, способствующими формированию СНсФВ, являются нарушения метаболизма в сердечной мышце, коронарная микрососудистая дисфункция, мультигормональные дефициты и другие, ещё не изученные факторы [2]. Начальная стадия СН определяется как бессимптомное нарушение сократительной и диастолической функций сердца, что предполагает стремление усовершенствовать существующие алгоритмы диагностики [3].…”

Section: рукописьunclassified

Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic

Shurkevich,

Vetoshkin,

Simonyan

et al. 2023

Russ J Cardiol

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Aim. To determine additional factors and sex differences associated with the intermediate probability of heart failure (HF) with preserved ejection fraction (HFpEF) in asymptomatic patients working in the Arctic on a rotating basis.Material and methods. In the polar village of Yamburg (68° 21' 40 "N), 99 men and 81 women with grade 1 and 2 hypertension (HTN) and normal blood pressure, comparable by age (p=0,450), length of service in the north (p=0,956), office systolic blood pressure (BP) (p=0,251), diastolic BP (p=0,579) were simultaneously examined. We performed echocardiography and assessed the risk of HFpEF by H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure). A treadmill test, Baevsky index, 24-hour BP monitoring, and biochemical blood tests were performed.Results. Depending on H2FPEF score, participants were divided into groups: from 0 to 1 (group 1 — normal), from 2 to 5 (group 2 — intermediate probability of HFpEF). In men with intermediate probability of HFpEF, the Baevsky index (p=0,0048) and the incidence of resting body reserve dysaptation (p=0,0394) were higher, as well as a rapid BP increase during dosed exercise (p=0,0058) and a decrease in chronotropic reserve (p<0,0001) were noted. The presence of HTN in men increased the intermediate probability of HFpEF by 3,6 times, dyspnea at dosed exercise by 10 times, dysaptation to exercise by 5 times, the presence of left ventricular concentric remodeling by 8-10 times. In females with intermediate probability of HFpEF, dysaptation to exercise at rest (p=0,0120) and lower level of oxygen consumption during dosed exercise was more often determined (p=0,0485). The intermediate probability of HFpEF in women increased with autonomic nervous system dysfunction, an increase in the mean 24-hour systolic BP variability, the presence of dyspnea during dosed exercise (10 times), concentric left ventricular remodeling, and an increase in nonspecific inflammation markers (high-sensitivity C-reactive protein, IL-1β, IL-6).Conclusion. Early identification of additional risk factors for intermediate probability of HFpEF in asymptomatic hypertensive patients has the potential to reduce the risk of subsequent clinical heart failure, allowing focus on prevention and intervention strategies in this group of patients.

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Section: рукописьunclassified

Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic

Shurkevich,

Vetoshkin,

Simonyan

et al. 2023

Russ J Cardiol

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Phenotyping of outpatients with heart failure with preserved ejection fraction and poor prognosis

Larina,

Lunev

2024

Russ J Cardiol

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The applicability of the left ventricular global function index (LVGFI) and its derivative, determined by echocardiography, to distinguish clinical phenotypes in a cohort of patients with heart failure with preserved ejection fraction (HFpEF) is unknown.Aim. To evaluate the differential diagnostic potential of LVGFI and its derivative when phenotyping outpatients aged ≥60 years with HFpEF.Material and methods. A total of 140 outpatients (men, 43%) aged 73 (67-78) years with functional class II-IV HFpEF were included in the study. The follow-up period was 34 (22-36) months.Results. LVGFI was 22,4 (19,4-24,6)%, while derivative index of LVGFI — 283,9 (248,9-332,2) ml. There were 18 (12,9%) deaths. The threshold value for predicting death for LVGFI was ≤21,4%, for derivative index of LVGFI — ≥303,6 ml. Based on cluster membership and mortality analysis, two following risk groups for death of patients with HFpEF were identified: a relatively low-risk (group 1) and moderate (group 2) risk group (mortality within 34 months ~25%). Group 1 was represented by patients, predominantly male, with class II HFpEF, coronary artery disease (CAD) and prior myocardial infarction (MI), concentric hypertrophy, a significant LV mass increase, a high frequency of bendopnea, lower LVGFI and higher derivative index of LVGFI. Group 2 was represented by patients, predominantly female, with class II HF, a history of CAD and myocardial infarction, concentric hypertrophy and concentric remodeling, a moderate LV mass increase, a relatively low frequency of bendopnea, higher LVGFI and lower derivative index of LVGFI. Based on the data obtained, an algorithm was developed to determine the risk of death in patients with HFpEF.Conclusion. LVGFI and its derivative index can be used in phenotyping patients with HFpEF. The developed algorithm for determining the death risk makes it possible to identify outpatients with HFpEF who need intensified therapy and observation by a general practitioner and cardiologist in order to reduce the risk of an unfavorable prognosis.

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Heart failure with preserved left ventricular ejection fraction: a comprehensive phenotype-based approach to diagnosis and treatment

Ларина¹,

Oynotkinova²,

Ларин³

et al. 2022

Kardiol. serdechno-sosud. khir.

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Novel algorithms for diagnosing heart failure with preserved ejection fraction in patients with hypertension and obesity

Cited by 4 publications

References 33 publications

Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic

Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic

Phenotyping of outpatients with heart failure with preserved ejection fraction and poor prognosis

Heart failure with preserved left ventricular ejection fraction: a comprehensive phenotype-based approach to diagnosis and treatment

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