Guidelines of the Ukrainian Association of Cardiology of the diagnosis, treatment and prevention of chronic heart failure in adults (short version)

Воронков, Л. Г.; Amosova, K.; Bagriy, A. E.; Дзяк, Г В

doi:10.15407/internalmed2015.01.065

Cited by 8 publications

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“…In order to prove CHF FC according to NYHA classification, and national guidelines of Ukraine [1], physical exercise in the form of the 6-min walk test was proposed to all patients. During the conducting of the test, a patient had to walk as long distance as possible in at own pace in 6 minutes in the corridor with 1-meter marks.…”

Section: Methodsmentioning

confidence: 99%

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Vitamin D Deficiency in Patients With Chronic Heart Failure and Morpho-Functional Condition of Peripheral Blood Erythrocytes

2020

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The aim: To assess the vitamin D level in blood plasma of patients with chronic heart failure and to identify the effect of its deficiency on the state of peripheral blood erythrocytes during physical exertion. Materials and methods: A total of 25 patients with CHF grade IIA stages II and III functional class were examined. The control group consisted of 25 relatively healthy people. All patients were offered to complete a 6 minutes walking test. The level of 25 (OH) D total in plasma was determined by enzyme immunoanalysis. Morphological studies of erythrocytes were performed on the light-optical (Leica CME) and electron-microscopic level («JEOL-25M-T220»). Results: Patients with chronic heart failure experienced 22.9% decrease in their vitamin D level (17.2±0.04 ng/ml) compared to the control group (38.4±0.05 ng/ml). Correlation analysis showed a direct proportional relationship between vitamin D deficiency and the number of erythrocytes of a modified form (r = 0.58; p <0.05) and erythrocytes with low osmotic resistance (r = 0.87; p <0.05). During the timed physical evaluation patients who experienced chronic heart failure accompanied by vitamin D deficiency developed an increase in the number of their reversibly and irreversibly deformed erythrocytes and a decrease in the cellular osmotic tability. Conclusions: During physical exertion, patients who experienced chronic heart falure accompanied by with vitamin D deficiency experienced morpho-biochemical changes in their red blood cells. These changes indicated structural disturbances in the membranes of their erythrocytes and could potentially have negative consequences for the somatic health of these patients.

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Section: Methodsmentioning

confidence: 99%

“…Сhronic heart failure (CHF) is one of the most common and prognostically unfavorable complications of most cardiovascular system diseases (CCS) [1]. Vitamin D deficiency or deficiency of 25-hydroxy-cholecalciferol (BD) is very likely to be an additional factor in the development of this pathology [2,15].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency in Patients With Chronic Heart Failure and Morpho-Functional Condition of Peripheral Blood Erythrocytes

2020

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“…Хворі з синусовим ритмом і фібриляцією передсердь зіставні за віком (70,30 ± 10,16 року проти 69,59 ± 8,45 року, р = 0,483), зростом (167,20 ± 10,21 см проти 170,24 ± 8,68 см, р = 0,345), масою тіла (80,21 ± 17,66 кг проти 86,93 ± 19,92 кг, р = 0,317), площею поверхні тіла (1,89 ± 0,23 м 2 проти 1,97 ± 0,24 м 2 , р = 0,153). Діагноз ХСН ішемічного ґенезу встановили відповідно до Рекомендацій з діагностики та лікування хронічної серцевої недостатності (2021) Асоціації кардіологів України та Української асоціації фахівців із серцевої недостатності [12].…”

Section: матеріали і методи дослідженняunclassified

The impact of renal tubulointerstitial dysfunction on the early and long-term prognosis in chronic heart failure patients with preserved left ventricular ejection fraction

Syvolap,

Lysenko,

Svitlyi

2024

Pathologia

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Aim. To study the dependence of the early-term (1 year) and long-term (5 years) prognosis in patients with chronic heart failure (CHF) of ischemic origin with preserved left ventricular ejection fraction (LVEF) depending on renal tubulointerstitial functional disorders. Materials and methods. The study involved 88 patients (men – 46.6 % (n = 41); women – 53.4 % (n = 47)) with CHF of ischemic origin, stage II A–B, stage II–IV according to NYHA, 67 % (n = 59) with sinus rhythm, and 33 % (n = 29) with atrial fibrillation. Patients with sinus rhythm and atrial fibrillation were matched in age (p = 0.483), height (p = 0.345), weight (p = 0.317), body surface area (p = 0.153). NGAL levels were analyzed using an ELISA kit (E-EL-H0096, Elabscience, USA). NAG levels were analyzed using an ELISA kit (SEA 069 Hu, Cloud-Clone Corp., USA). KIM-1 levels were analyzed using an ELISA kit (SEA 785 Hu, Cloud-Clone Corp., USA). Kaplan–Meier curves and Cox proportional hazards regression analysis were performed. Results. No significant difference was found in the frequency of the cumulative endpoint during the first-year follow-up from the initial level of two markers of tubulointerstitial injury – KIM-1 (Log-Rank Test: p = 0.57529) and NAG (Log-Rank Test: p = 0.86001). According to the results of analysis of the Cox proportional hazards, only a tendency to increase in the risk factors of adverse events were observed in case of elevated KIM-1 (HR = 1.66; p = 0.5795) and NAG levels (HR = 1.1712; p = 0.8626) in this CHF patients’ cohort. Kaplan–Meier analysis revealed a probable (Log-Rank Test; p = 0.00141) increase in the frequency of the cumulative endpoint during the first year of follow-up in CHF patients with preserved LVEF due to increased serum NGAL level more than 168 ng/ml. According to the univariate model, an elevated serum NGAL level is associated with an increase in the relative risk by 4.2 times (95 % CI 1.78–16.89; p = 0.014). A reduced sodium level less than 142.5 mmol/l was associated with an increase in number of adverse cardiovascular events during the first-year follow- ups by 22 % (HR = 1.22, p = 0.029). After 5 years of follow-up, a decrease in sodium level less than 142.3 mmol/l is also characterized by a probable difference of the cumulative Kaplan–Meier’s curves (Cox–Mantel F-Test, p = 0.00287). According to the univariate model of Cox proportional hazards, the relative risk of adverse cardiovascular events in patients with CHF during the 5-year follow-up has a tendency to increase by 1.04 times (95 % CI 0.85–1.27; p = 0.72). Serum NGAL, a marker of renal tubulo-interstitial injury, doesn’t lose its properties as a powerful marker of an unfavorable long-term prognosis in patients with CHF with preserved LVEF (HR = 5.96; 95 % CI 1.17–30.50; p = 0.032). Conclusions. The most powerful factors of the early (1-year) prognosis of adverse cardiovascular events in CHF patients with preserved left ventricular ejection fraction are the marker of tubulointerstitial injury, serum NGAL over 168 ng/ml, as well as the marker of tubulointerstitial dysfunction – the serum sodium level less than 142.5 mmol/l. The electrolyte imbalance, decreased sodium level less than 142.3 mmol/l, remains a powerful marker of an unfavorable long-term 5-year prognosis in CHF patients with preserved left ventricular ejection fraction, meanwhile serum NGAL, a marker of renal tubulointerstitial injury, besides doesn’t lose its prognostic value (HR = 5.96; 95 % CI 1.17–30.50; p = 0.032), but also is independent from the parameters of the age (p = 0.409) and gender (p = 0.397) in such patients.

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“…Це призводить до зниження серцевого викиду, збільшення порожнин серця. У відповідь на розтягнення міокарда лівого шлуночка та на підвищення тиску в ньому підвищується продукція мозкового натрійуретичного пептиду [6,18]. У свою чергу, натрійуретичний пептид має захисні властивості щодо серцево-судинної системи, виявляючи натрійуретичний ефект і знижуючи тонус судин, що призводить до гіпотензивного ефекту завдяки розширенню судин [19,20].…”

Section: таблиця 1 функціональні показники серця у підлітків з ювеніл...unclassified

Adaptive capabilities of the cardiovascular system, taking into account regulation systems, in adolescents with juvenile idiopathic arthritis

Holovko

Bogmat

Shevchenko

et al. 2023

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Background. Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood (1 : 1,000 children), which involves many organs and systems, primarily cardiovascular, with the gradual development of chronic heart failure. As you know, when the functional capacity of the heart decreases, a cascade of reactions of the neurohumoral regulation system is triggered and, first of all, the sympathoadrenal system is activated with an increase in the catecholamine production, the development of tachycardia. Due to this, the level of brain natriuretic peptide in the blood is increased. In children, chronic heart failure is asymptomatic. Therefore, determining tolerance to physical exertion plays an important role in its diagnosis. The purpose was to determine the functional state of the cardiovascular system and the tolerance to physical exertion in adolescents with JIA, taking into account the level of catecholamine excretion in the daily urine and the level of natriuretic peptide in the blood. Materials and methods. Fifty-six patients with JIA aged 12–17 years (13.28 ± 0.38 years) were examined. The control group consisted of 46 apparently healthy peers of the corresponding age. A heart ultrasound was performed to establish the functional state of the myocardium. To study tolerance to physical exertion, a six-minute walk test was performed with calculation of Kerdo index before and after the test. The level of catecholamine excretion in the urine and the level of natriuretic peptide in the blood were studied. Results. Patients with juvenile idiopathic arthritis had early signs of right ventricular myocardial systolic dysfunction (a decrease in the right ventricular ejection fraction). At the same time, we detected a decrease in the catecholamine level and an increase in the content of natriuretic peptide, which has a neuromodulatory effect at different levels of the sympathoadrenal system. Conclusions. Activation of the sympathetic division of the autonomic nervous system (increased Kerdo index) in patients with juvenile idiopathic arthritis does not ensure the effectiveness of minimal physical exertion in a six-minute walk test.

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Guidelines of the Ukrainian Association of Cardiology of the diagnosis, treatment and prevention of chronic heart failure in adults (short version)

Cited by 8 publications

References 0 publications

Vitamin D Deficiency in Patients With Chronic Heart Failure and Morpho-Functional Condition of Peripheral Blood Erythrocytes

Vitamin D Deficiency in Patients With Chronic Heart Failure and Morpho-Functional Condition of Peripheral Blood Erythrocytes

The impact of renal tubulointerstitial dysfunction on the early and long-term prognosis in chronic heart failure patients with preserved left ventricular ejection fraction

Adaptive capabilities of the cardiovascular system, taking into account regulation systems, in adolescents with juvenile idiopathic arthritis

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