Peculiarities of Hemodynamics in Patients With Chronic Heart Failure Considering Sex Dimorphism

Abstract

Introduction. Heart failure is an important factor in the development of pathological processes and pathophysiological manifestations; it can be modified at all stages of its development, regardless of sex and age, and be accompanied by arterial hypertension, heart ischemia, tachycardia, bradycardia, etc. The purpose of this study is to investigate the peculiarities of central hemodynamics in cases of chronic heart failure considering sex dimorphism. Materials and methods. The research comprised 149 individuals, aged between 18 and 75, with long-term heart failure, who received inpatient treatment at the Heart Failure Department of the National Centre of Cardiology "Acad. M.D. Strazhesko Institute of Cardiology” of the National Academy of Sciences of Ukraine for 2020 – 2022. Objective criteria such as heart rate, systolic and diastolic blood pressure, pulse pressure, systolic blood volume, and minute blood volume were used to assess the state of the cardiovascular system. All patients underwent an echocardiogram in M- and B-modes to assess the structural and functional state of the heart and to establish an accurate diagnosis. Results. Analyzing the obtained results, it should be noted that there is a certain sexual dimorphism in the indicators of central hemodynamics in patients with chronic heart failure: for instance, women with chronic heart failure demonstrates significantly higher values of blood pressure and pulse pressure than men with the same diagnosis. The values of minute blood volume in patients with chronic heart failure of both sexes were within the reference values. More pronounced changes in central hemodynamic parameters under chronic heart failure were observed in women compared to men. It should be noted that all investigations were conducted while individuals were receiving medical therapy for heart failure. It is note worthy that the results of the echocardiographic examination indicate profound changes in the heart structure in the patients with chronic heart failure. In particular, the set of the evaluated indicators point out left ventricle hypertrophy. The degree of hypertrophy provides unquestionable predictive value. Remodelling of the myocardium is a possible occurrence linked to arterial hypertension. Conclusion. Central hemodynamic indicators reveal sex dimorphism, with greater distinction observed in the patients with chronic heart failure, particularly among women. Despite this, the main indicators of hemodynamics in patients with chronic heart failure were within the reference values, which can be explained by the fact that the patients received drug therapy. However, the analysis of indicators obtained by echocardiographic study indicates profound changes in the heart structure in patients with chronic heart failure, which are more pronounced in male patients compared to their female counterparts.