Pulmonary embolism in the presence of chronic heart failure syndrome: A structural-functional state of the cardiovascular system

Abstract

<jats:p><jats:bold>Aim.</jats:bold> To identify the features of the structural-functional state of the cardiovascular system in patients with pulmonary embolism (PE) in the presence of chronic heart failure (CHF) syndrome.</jats:p><jats:p><jats:bold>Material and Methods</jats:bold>. The study included 231 patients diagnosed with PE at admission to the hospital. Patients were further divided into subgroups depending on the verification of the diagnosis by computed tomography and the presence of CHF syndrome.</jats:p><jats:p><jats:bold>Results and discussion</jats:bold>. An increase in pressure in the pulmonary artery system contributed to the formation and aggravation of right ventricular systolic dysfunction, which acquired a greater prevalence and severity in the presence of CHF. This was confirmed by the echocardiographic signs of dysfunction of the right heart including increased linear dimensions of right cardiac chambers, right atrium volume index of 32.3 (29.4–37.9) mL/m2 versus 29.1 (26.6–32.3) mL/m2 (U = 1583.00, p &lt; 0.001); greater prevalence of hemodynamic instability (proportion of patients with fainting or presyncope at hospital admission was 32% in the presence of CHF versus 16.7% without CHF; χ2 = 4,49, p &lt; 0.05); and more significant increases in the laboratory markers of right ventricular dysfunction and injury included in the prediction model of adverse PE outcome [brain natriuretic peptide of 395 (204–789) pg/mL versus 104.2 (38.9–212) pg/mL (U = 1162.00, p &lt; 0.001), high-sensitive troponin of 212 (194.5–297.6) ng/mL versus 184.8 (168.0–194.8) ng/mL (U = 279.50, p &lt; 0.01), myocardial fatty acid-binding protein of 0.37 (0.18–1.2) ng/mL versus 0.2 (0.08–0.3) ng/mL (U = 530.00, p &lt; 0.001), copeptin of 0.2 (0.05–0.92) ng/mL versus 0.09 (0.04–0.15) ng/mL (U = 563.00, p &lt; 0.01), and reduced renal function]. </jats:p>