Pilot project “Improvement of medical care for patients with chronic heart failure”: results of the first stage

Murtazalieva, P; Karelkina, E; Шишкова, А. А.; Зайцев, В. В.; Звартау, Н. Э.; Моисеева, О. М.

doi:10.15829/1560-4071-2018-12-44-51

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…В настоящее время ожирение рассматривается как хроническое заболевание, ведущее к развитию многочисленных осложнений, которые нередко требуют междисциплинарного подхода [1]. Особое внимание привлекает взаимосвязь развития хронической сердечной недостаточности (ХСН) и ожирения [2]. Одним из механизмов развития ХСН при ожирении являются метаболические нарушения в миокарде, возникающие при висцеральном ожирении.…”

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The relationship of epicardial obesity and levels of cardiac fibrosis markers

et al. 2019

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Lipotoxic myocardial damage with its fibrosis and subsequent formation of heart failure may develop due to epicardial obesity (EO). The possibility of early diagnosis of lipotoxic cardiac fibrosis is not well understood.Aim.To study the relationship of EO with the level of myocardial fibrosis markers.Material and methods.The study included 80 men aged 54,3±8,2 with grades I-III obesity. The level of metabolic factors, pro-inflammatory cytokines, adipokines (adiponectin, leptin), soluble leptin receptor and free fatty acids was determined for all patients; the presence of EO was determined by echocardiography with epicardial fat thickness (EFT) ≥7 mm. Coronary artery disease, arterial hypertension, type 2 diabetes mellitus, the presence of left ventricular diastolic dysfunction were the exclusion criteria of the study.Results.The patients were divided into 2 groups: group I with EO (n=49) and group II without EO (n=31). Group I showed a statistically significant increase in the levels of interleukin-6 (IL-6), C-reactive protein, tumor necrosis factor-α (TNF-α), leptin, a decrease in adiponectin, as well as an increase in all studied myocardial fibrosis markers. In addition, in the group with EO, a positive relationship between the EFT and TNF-α (r=0,29; p=0,041), IL-6 (r=0,28; p=0,049), leptin (r=0,41; p=0,004) and a negative relationship with the level of adiponectin (r=-0,29; p=0,042). We determine a significant effect of the degree of EO on the increase in the level of cardiac fibrosis markers (r=0,28, p=0,049), collagen (r=0,33, p=0,019), transforming growth factor-β (r=0,29, p=0,045).Conclusion.The results suggest that elevated levels of profibrotic factors in patients with EO may be signs of the presence of preclinical, and therefore, earlier lipotoxic myocardial fibrosis, which was not detected during echocardiographic research in the form of diastolic dysfunction.

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The relationship of epicardial obesity and levels of cardiac fibrosis markers

et al. 2019

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“…At the core of LR is LR in the hypothalamus and a decrease in the number of leptin receptors [11]. In particular, there is a well-established relationship between obesity and chronic heart failure (CHF) development [12][13][14]. During obesity, CHF develops as a result of metabolic disorders of the myocardium, and they occur due to visceral obesity [2].…”

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Analysis of probable lipotoxic damage and myocardial fibrosis in epicardial obesity

Чумакова¹,

Гриценко²,

Груздева³

et al. 2021

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Myocardial fibrosis is considered a key pathological process in the development of cardiovascular diseases. In epicardial obesity (EO), the main cause of fibrosis development is lipotoxic myocardial damage. It is important to detect myocardial fibrosis at an early stage, using non-invasive diagnostic methods. According to the results of echocardiography (ECG), 110 men with general obesity were divided into the following two groups: Group I with epicardial fat thickness (tEAT) ≥ 7 mm (n = 70) and Group II with tEAT < 7 mm (n = 40) without diastolic dysfunction. The levels of metabolic factors, pro-inflammatory cytokines, adipokines, and free fatty acids (FFA), profibrotic markers were determined in both groups. In Group I, the level of interleukin (IL)-6, C-reactive protein, and tumor necrosis factor (TNF)-α increased and that of leptin and adiponectin decreased compared with those in Group II. There was an increase in the level of all studied profibrotic factors in Group I. The level of TNF-α and IL-6 showed a positive correlation with the level of leptin and FFA and a negative correlation with the level of adiponectin. We also observed a relationship between the level of collagen, transforming growth factor (TGF)-β, and metalloproteinase (MMP)-3 and EO. Our results showed that confirmed EO correlates with not only disadipocytosis and increased levels of pro-inflammatory cytokines, but also increased levels of profibrotic factors. This suggests that the studied markers of fibrosis may be used to determine preclinical cardiac fibrosis with lipotoxic myocardial damage in patients with EO.

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Compliance of the management of hospitalized patients with heart failure with the quality criteria for health care: data from the St. Petersburg registry

Endubaeva,

Solovyova,

Medvedev

et al. 2023

Russ J Cardiol

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Aim. To assess the compliance of the management of patients with heart failure (HF) with quality criteria (QC) for health care, including discharge instructions for patients.Material and methods. Hospitalizations of patients aged over 18 years with HF (ICD 10 code — I50.x) during the period from January 1, 2019 to October 1, 2020 were randomly selected from the "Chronic Heart Failure" registry of St. Petersburg. Discharge and post-mortem summaries were assessed for compliance with the quality criteria listed in the 2020 Russian Chronic Heart Failure guidelines.Results. The study included 553 patients (women, 71,1%, mean age, 82,0±9 years, comorbidities: hypertension — 99,1%, coronary artery disease — 97,6%, chronic kidney disease — 53,2%, diabetes — 32,6%). Electrocardiography (QC № 1) was performed in 94,2% of patients, chest radiography (QC № 2) 91,7%, echocardiography (QC № 3) — 81,0%, but the results were not always informative. The exact ejection fraction (EF) value was reported in 55,4% of patients. Laboratory examination corresponded to QC № 4-6 in 20,3% of cases and was performed in 53,3-94,9%. Natriuretic peptides (NPs) were not determined (QC № 7-0%).The completeness of intravenous therapy (QC № 8) was not assessed due to insufficient physical examination data.Oral therapy (QC № 9) was prescribed frequently as follows: renin-angiotensinaldosterone system inhibitors (RAASo) — 93,3%, beta blockers (BBs) — 85,4%, mineralocorticoid receptor antagonists (MRAs) — 78,7%. However, triple RAAS+BB+MRA therapy was carried out in 54,1% of HF cases with EF <50% and no contraindications.Diet was recommended in 87,1% of summaries, water-salt regimen — 53,3%, drug titration — 8,2%. The date of visit to outpatient cardiologist was indicated in 10,0%.Conclusion. With the exception of NP assessment, the scope of paraclinical studies corresponded to the QC in the majority of patients. Optimal therapy was prescribed to 54,1% of patients with EF <50%. An early outpatient visit after discharge was indicated in 10,0% of summaries.

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Pilot project “Improvement of medical care for patients with chronic heart failure”: results of the first stage

Cited by 4 publications

References 10 publications

The relationship of epicardial obesity and levels of cardiac fibrosis markers

The relationship of epicardial obesity and levels of cardiac fibrosis markers

Analysis of probable lipotoxic damage and myocardial fibrosis in epicardial obesity

Compliance of the management of hospitalized patients with heart failure with the quality criteria for health care: data from the St. Petersburg registry

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