{"title":"Risk factors for complications during recanalization of chronic coronary artery occlusions in patients with coronary artery disease","authors":"E. Aksenov","doi":"10.30978/HV2018-4-74","DOIUrl":"https://doi.org/10.30978/HV2018-4-74","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88357604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Heart failure with preserved ejection fraction: phantom or real independent syndrome with «own face»?","authors":"K. Amosova","doi":"10.30978/hv2018-4-7","DOIUrl":"https://doi.org/10.30978/hv2018-4-7","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81885308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Panchuk, V. Mishalov, I. Leschishin, O. I. Ohotskaya, A. Smolnikov
{"title":"Doppler flowmetry in determination and evaluation of blood flow characteristics in anterior abdominal wall vessels during lipoabdominoplasty","authors":"O. Panchuk, V. Mishalov, I. Leschishin, O. I. Ohotskaya, A. Smolnikov","doi":"10.30978/HV2018-4-40","DOIUrl":"https://doi.org/10.30978/HV2018-4-40","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88928117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Mishalov, I. Leschishin, O. I. Okhotska, P. Byk, P. Minchenko, O. Panchuk, S. M. Pakrishen
{"title":"Endometrioma of the rectus abdominis","authors":"V. Mishalov, I. Leschishin, O. I. Okhotska, P. Byk, P. Minchenko, O. Panchuk, S. M. Pakrishen","doi":"10.30978/hv2018-3-89","DOIUrl":"https://doi.org/10.30978/hv2018-3-89","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84441958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Amosova, O. Vasylenko, Yu. V. Rudenko, A. Bezrodniy, G. Mostbauer, K. Lazarieva, Igor Prudkiy, E. V. Andreiev, P. Lazariev, Y. Sychenko, I. Gorda, A. Sablin, N. V. Melnichenko, A. Soloshchenko
The aim — to determine the frequency of different combinations of criteria of heart failure (HF) with preserved ventricular ejection fraction (EF), established by the European Society of Cardiology (ESC) in 2016, in symptomatic patients with arterial hypertension (AH) in clinical practice and to assess their relationship to the clinical profile and the structural and functional state of the heart and arteries. Materials and methods. The study included 103 patients aged 43 to 85 years, with symptoms and signs of HF, AH and LVEF ³ 50 %, which had signs of diastolic dysfunction (DD) according to Doppler EchoCG data. The level of Nterminal fragment of the brain natriuretic peptide (NTproBNP) was assessed by an enzyme immunoassay. The pulse wave velocity (carotidfemoral) (PWVcf) was assessed using applanation tonometry. Using ECG, the back wall thickness (BWT) of the left ventricle (LV) and interventricular septal thickness (IST), enddiastolic index (EDI) and endsystolic index (ESI) of the LV, left ventricular myocardial index (LVMI), left atrium volume index (LAVI) and left ventricular ejection fraction (LVEF). Early (E) and late diastolic left ventricular filling velocity (A), E/A ratio, diastolic speed of septal and lateral motion of fibrous mitral valve ring, the mean value e¢, the relation Е/e¢, tricuspidal regurgitation velocity (TRV), the deceleration time of early diastolic filling (DT) and left ventricular isovolumic relaxation time (IVRT), and systolic pulmonary artery pressure (SPAP) — with the use of Doppler EchoCG were evaluated. Patients with ratio E/e¢ 9 — 13 at rest underwent diastolic stress test. Results and discussion. According to the ESC algorithm, HF was absent in 11 (10.6 %) patients (group 1); 28 (30.4 %) patients had structural criteria and no functional criteria (group 2); 64 (69.5 %) patients had three structural and functional criteria of HF according to ESC algorithm (group 3). High left ventricular filling pressure (LVFP) was found in all 35 (54.6 %) patients of group 3 without atrial fibrillation (AF) and in 7 (26.9 %) patients of group 3. Normal left ventricular filling pressure was found in all patients of group 1 and 7 (26.9 %) patients of group 2. Left ventricular filling pressure could not be identified in 4 (36.3 %) patients of group 1 and 12 (46.1 %) patients of group 2 (all p < 0.01). AF was present in 29 (45.3 %) patients of group 3 and in 2 patients (7.1 %) of group 2 (p < 0.01). Increase in SPAP was noted in 52 (81.2 %) patients of group 3 and 4 (14.2 %) patients of group 2 (p < 0.01). The dilatation of the right ventricle (RV) was more pronounced in group 3 than in groups 2 and 1 (p < 0.01 and p < 0.05). Patients of groups 1 and 2 were comparable according to PWVcf, patients of group 3 had higher values of this indicator than those of groups 2 and 1 (all p < 0.01). E/e¢ while exercise stress was more than 13 in 78.5 % patients of group 2 and in 18.2 % of group 1 (p < 0.01). Groups 2 and 3 had high levels
{"title":"Heterogeneity of patients with arterial hypertension and heart failure with preserved left ventricular ejection fraction according to the clinical and structural-functional profile of the heart and arteries depending on the available diagnostic criteria o","authors":"K. Amosova, O. Vasylenko, Yu. V. Rudenko, A. Bezrodniy, G. Mostbauer, K. Lazarieva, Igor Prudkiy, E. V. Andreiev, P. Lazariev, Y. Sychenko, I. Gorda, A. Sablin, N. V. Melnichenko, A. Soloshchenko","doi":"10.30978/HV2018-3-41","DOIUrl":"https://doi.org/10.30978/HV2018-3-41","url":null,"abstract":"The aim — to determine the frequency of different combinations of criteria of heart failure (HF) with preserved ventricular ejection fraction (EF), established by the European Society of Cardiology (ESC) in 2016, in symptomatic patients with arterial hypertension (AH) in clinical practice and to assess their relationship to the clinical profile and the structural and functional state of the heart and arteries. Materials and methods. The study included 103 patients aged 43 to 85 years, with symptoms and signs of HF, AH and LVEF ³ 50 %, which had signs of diastolic dysfunction (DD) according to Doppler EchoCG data. The level of Nterminal fragment of the brain natriuretic peptide (NTproBNP) was assessed by an enzyme immunoassay. The pulse wave velocity (carotidfemoral) (PWVcf) was assessed using applanation tonometry. Using ECG, the back wall thickness (BWT) of the left ventricle (LV) and interventricular septal thickness (IST), enddiastolic index (EDI) and endsystolic index (ESI) of the LV, left ventricular myocardial index (LVMI), left atrium volume index (LAVI) and left ventricular ejection fraction (LVEF). Early (E) and late diastolic left ventricular filling velocity (A), E/A ratio, diastolic speed of septal and lateral motion of fibrous mitral valve ring, the mean value e¢, the relation Е/e¢, tricuspidal regurgitation velocity (TRV), the deceleration time of early diastolic filling (DT) and left ventricular isovolumic relaxation time (IVRT), and systolic pulmonary artery pressure (SPAP) — with the use of Doppler EchoCG were evaluated. Patients with ratio E/e¢ 9 — 13 at rest underwent diastolic stress test. Results and discussion. According to the ESC algorithm, HF was absent in 11 (10.6 %) patients (group 1); 28 (30.4 %) patients had structural criteria and no functional criteria (group 2); 64 (69.5 %) patients had three structural and functional criteria of HF according to ESC algorithm (group 3). High left ventricular filling pressure (LVFP) was found in all 35 (54.6 %) patients of group 3 without atrial fibrillation (AF) and in 7 (26.9 %) patients of group 3. Normal left ventricular filling pressure was found in all patients of group 1 and 7 (26.9 %) patients of group 2. Left ventricular filling pressure could not be identified in 4 (36.3 %) patients of group 1 and 12 (46.1 %) patients of group 2 (all p < 0.01). AF was present in 29 (45.3 %) patients of group 3 and in 2 patients (7.1 %) of group 2 (p < 0.01). Increase in SPAP was noted in 52 (81.2 %) patients of group 3 and 4 (14.2 %) patients of group 2 (p < 0.01). The dilatation of the right ventricle (RV) was more pronounced in group 3 than in groups 2 and 1 (p < 0.01 and p < 0.05). Patients of groups 1 and 2 were comparable according to PWVcf, patients of group 3 had higher values of this indicator than those of groups 2 and 1 (all p < 0.01). E/e¢ while exercise stress was more than 13 in 78.5 % patients of group 2 and in 18.2 % of group 1 (p < 0.01). Groups 2 and 3 had high levels","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84841443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Voronkov, G. Dudnik, A. Liashenko, T. Gavrilenko, L. Mkhitaryan, G. Ponomareva
The aim — to elucidate the predictors of renal dysfunсtion (RD) in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF). Materials and methods. 134 patients were examined with stable CHF, II — IV NYHA functional class (FC), and LVEF < 40 %. Median age was 59.5 [54; 68] years. All patients underwent general clinical examination. Glomerular filtration rate was calculated. The levels of interleukin6, insulin, NTproBNP, uric acid, blood urea nitrogen, levels of microalbuminuria were determined. Ultrasound diagnosis of the vasodilating function of the endothelium of the brachial artery was performed using a test with reactive hyperemia. The patients were treated according to the current guidelines of the Association of Cardiologists of Ukraine on the diagnosis and treatment of chronic heart failure. Results and discussion. RD was detected in 39.5 % of the patients examined. Older patients, women, patients with coronary heart disease (CHD), arterial hypertension (AH), diabetes mellitus, anemia, and also III — IV NYHA class have a greater chance of having RD. The presence of myocardial infarction (MI), atrial fibrillation (AF), smoking in the anamnesis did not reveal significance in calculating the odds ratio. None of the major hemodynamic and echocardiographic parameters was a predictor of PD. Among the laboratory indices, independent predictors of RD were detected levels of blood urea nitrogen, uric acid, and citrulline levels.The results obtained indicate the priority role of neurohumoral activation, inflammation and oxidative stress in the formation of RD. Conclusions. The independent laboratory predictors of RD in 39.5 % of the patients with CHF and a reduced LVEF are the levels of blood urea nitrogen, uric acid and citrulline in the plasma. Its risk increases with age, NYHA class, the duration of CHF, and in the presence of such comorbidities as AH, CHD, diabetes mellitus, anemia. The presence of RD is not associated with MI in anamnesis or the presence of AF, parameters of central hemodynamics, parameters of LV structuralfunctional states, level of microalbuminuria, ratio of albumin/creatinine, level of glucose, insulin, interleukin6 and NTproBNP in plasma.
{"title":"Predictors of renal dysfunction in patients with chronic heart failure and reduced left ventricular ejection fraction","authors":"L. Voronkov, G. Dudnik, A. Liashenko, T. Gavrilenko, L. Mkhitaryan, G. Ponomareva","doi":"10.30978/HV2018-3-36","DOIUrl":"https://doi.org/10.30978/HV2018-3-36","url":null,"abstract":"The aim — to elucidate the predictors of renal dysfunсtion (RD) in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF). Materials and methods. 134 patients were examined with stable CHF, II — IV NYHA functional class (FC), and LVEF < 40 %. Median age was 59.5 [54; 68] years. All patients underwent general clinical examination. Glomerular filtration rate was calculated. The levels of interleukin6, insulin, NTproBNP, uric acid, blood urea nitrogen, levels of microalbuminuria were determined. Ultrasound diagnosis of the vasodilating function of the endothelium of the brachial artery was performed using a test with reactive hyperemia. The patients were treated according to the current guidelines of the Association of Cardiologists of Ukraine on the diagnosis and treatment of chronic heart failure. Results and discussion. RD was detected in 39.5 % of the patients examined. Older patients, women, patients with coronary heart disease (CHD), arterial hypertension (AH), diabetes mellitus, anemia, and also III — IV NYHA class have a greater chance of having RD. The presence of myocardial infarction (MI), atrial fibrillation (AF), smoking in the anamnesis did not reveal significance in calculating the odds ratio. None of the major hemodynamic and echocardiographic parameters was a predictor of PD. Among the laboratory indices, independent predictors of RD were detected levels of blood urea nitrogen, uric acid, and citrulline levels.The results obtained indicate the priority role of neurohumoral activation, inflammation and oxidative stress in the formation of RD. Conclusions. The independent laboratory predictors of RD in 39.5 % of the patients with CHF and a reduced LVEF are the levels of blood urea nitrogen, uric acid and citrulline in the plasma. Its risk increases with age, NYHA class, the duration of CHF, and in the presence of such comorbidities as AH, CHD, diabetes mellitus, anemia. The presence of RD is not associated with MI in anamnesis or the presence of AF, parameters of central hemodynamics, parameters of LV structuralfunctional states, level of microalbuminuria, ratio of albumin/creatinine, level of glucose, insulin, interleukin6 and NTproBNP in plasma.","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87523860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Borkhalenko, O. Zharinov, K. Mikhaliev, O. Yepanchintseva, B. Todurov
The aim — to compare the changes of the values of quality of life (QoL) in patients with stable coronary artery disease and preserved left ventricular (LV) ejection fraction (EF) within 6 months after revascularization interventions (coronary artery bypass grafting — CABG, or percutaneous coronary intervention — PCI) and to identify the factors that may affect QoL changes. Materials and methods. A singlecenter prospective study included data from a clinical, instrumental and laboratory examination of 115 patients (91 (79.1 %) men and 24 (20.9 %) women aged 32 to 92 years (mean age — 63 ± 10) with CAD and preserved LV systolic function (LVEF ≥ 45 %) consecutively selected for CABG (n = 71) or coronary stenting (n = 44). QoL was assessed by MLHFQ, SAQ and SF36 questionnaires before and 6 months after myocardial revascularization. Also, changes in the distance of 6minute walking test, Doppler echocardiographic indices of the LV diastolic function and the level of the brain natriuretic peptide (BNP) were analyzed. Results and discussion. After 6 months of followup in the study groups, the levels of QoL according to MLHFQ, SF36 and SAQ scores significantly improved, compared to the baseline data (p < 0.001). In both groups there was a decrease of the functional class of angina by the Canadian classification (p < 0.001). There were no significant differences in the manifestation of stable angina pectoris in the compared groups after 6 months (p = 0.237). Improvement of QoL was associated with decrease of the BNP level from baseline 108.8 (50.1 — 185.4) to 32.3 (12.6 — 57.8) pg/ml in the stenting group (p = 0.002) and from 115.4 (62.0 — 150.6) to 52.4 (20.4 — 95.9) pg/ml in the CABG group (p < 0.001). The distance of the 6minute walk test in the stenting group increased from 223 (148 — 328) m to 550 (400 — 600) m; in the CABG group this distance was, respectively, 260 (195 — 300) and 550 (415 — 600) m. Conclusions. Thus, in patients with stable ischemic coronary disease and preserved LV systolic function after coronary artery stenting or CABG, a significant improvement of QoL values was observed, compared to the baseline data. Favorable changes in QoL may be due to a decrease of angina pectoris, improvement of the Doppler echocardiographic parameters of LV diastolic function and functional status of the patients. The abovementioned changes were associated with decrease of the BNP level.
{"title":"Changes in the quality of life of patients with stable ischemic heart disease and preserved left ventricular ejection fraction after coronary artery bypass grafting or stenting at 6-month follow-up","authors":"Y. Borkhalenko, O. Zharinov, K. Mikhaliev, O. Yepanchintseva, B. Todurov","doi":"10.30978/hv2018-3-66","DOIUrl":"https://doi.org/10.30978/hv2018-3-66","url":null,"abstract":"The aim — to compare the changes of the values of quality of life (QoL) in patients with stable coronary artery disease and preserved left ventricular (LV) ejection fraction (EF) within 6 months after revascularization interventions (coronary artery bypass grafting — CABG, or percutaneous coronary intervention — PCI) and to identify the factors that may affect QoL changes. Materials and methods. A singlecenter prospective study included data from a clinical, instrumental and laboratory examination of 115 patients (91 (79.1 %) men and 24 (20.9 %) women aged 32 to 92 years (mean age — 63 ± 10) with CAD and preserved LV systolic function (LVEF ≥ 45 %) consecutively selected for CABG (n = 71) or coronary stenting (n = 44). QoL was assessed by MLHFQ, SAQ and SF36 questionnaires before and 6 months after myocardial revascularization. Also, changes in the distance of 6minute walking test, Doppler echocardiographic indices of the LV diastolic function and the level of the brain natriuretic peptide (BNP) were analyzed. Results and discussion. After 6 months of followup in the study groups, the levels of QoL according to MLHFQ, SF36 and SAQ scores significantly improved, compared to the baseline data (p < 0.001). In both groups there was a decrease of the functional class of angina by the Canadian classification (p < 0.001). There were no significant differences in the manifestation of stable angina pectoris in the compared groups after 6 months (p = 0.237). Improvement of QoL was associated with decrease of the BNP level from baseline 108.8 (50.1 — 185.4) to 32.3 (12.6 — 57.8) pg/ml in the stenting group (p = 0.002) and from 115.4 (62.0 — 150.6) to 52.4 (20.4 — 95.9) pg/ml in the CABG group (p < 0.001). The distance of the 6minute walk test in the stenting group increased from 223 (148 — 328) m to 550 (400 — 600) m; in the CABG group this distance was, respectively, 260 (195 — 300) and 550 (415 — 600) m. Conclusions. Thus, in patients with stable ischemic coronary disease and preserved LV systolic function after coronary artery stenting or CABG, a significant improvement of QoL values was observed, compared to the baseline data. Favorable changes in QoL may be due to a decrease of angina pectoris, improvement of the Doppler echocardiographic parameters of LV diastolic function and functional status of the patients. The abovementioned changes were associated with decrease of the BNP level.","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75297082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Amosova, K. I. Chernyayeva, Yu. V. Rudenko, A. Bezrodniy, N. Shyshkina
{"title":"Phenotype-oriented approach to clinical evaluation of patients with chronic heart failure with preserved left ventricular ejection fraction","authors":"K. Amosova, K. I. Chernyayeva, Yu. V. Rudenko, A. Bezrodniy, N. Shyshkina","doi":"10.30978/hv2018-3-76","DOIUrl":"https://doi.org/10.30978/hv2018-3-76","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80570308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The man who invented modern surgery. To the 110th jubilee of Michael Ellis DeBakey","authors":"S. Genyk","doi":"10.30978/HV2018-3-95","DOIUrl":"https://doi.org/10.30978/HV2018-3-95","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88919434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Voronkov, A. Solonovych, A. Liashenko, I. Revenko, L. Mkhitaryan
The aim — to establish clinical factors associated with cognitive dysfunction (CD) in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LV EF). Materials and methods. We examined 124 patients aged 18 to 75 years with CHF II — IV functional class according to the criteria of the New York Heart Association (NYHA). The cognitive function was assessed using a minimental state examination (MMSE), the Schulte test, the HADS scale. The number of points on the MMSE scale £ 26 indicated the presence of CD. In addition to the standard general clinical examination, the quality of life was assessed by the MLHFQ (The Minnesota Living with Heart Failure Questionnaire), the physical activity index was calculated using the Duke Activity Status index (DASI), a 6minute walk test, an immunoassay study (levels of interleukin6, Nterminal fragment of the brain natriuretic peptide and insulin were determined), ultrasound diagnosis of the vasodilating function of the endothelium of the brachial artery (fluxdependent vasodilation (FDVD)) using a sample with a reactive hyperemia. Results and discussion. CD was observed in 85 (68.6 %) patients. There was no statistically significant effect of sex, LVEF value, the influence of atrial fibrillation on the state of cognitive function. CD in patients with CHF and decreased LVEF was associated with the worst functional class by NYHA (p = 0.001), the presence of hypertension, coronary heart disease and renal dysfunction (p = 0.037, p = 0.021 and p = 0.032, respectively). Patients with CD were statistically significantly older (p = 0.002), had worse quality of life by MLHFQ (p = 0.04) and low DASI (p = 0.037), a high level of depression on the HADS scale (p = 0.032), lower glomerular filtration rate (p = 0.012), greater thickness of the posterior wall of the left ventricle (p = 0.011), inferior FDVD (p = 0.049) compared to patients without CD. The number of points on the MMSE scale directly correlated with the distance of a 6minute walk (r = 0.264, p = 0.003), the DASI value (r = 0.275, p = 0.002), the glomerular filtration rate (r = 0.275, p = 0.002), FDVD (r = 0.207, p = 0.021) and the activity of superoxide dismutase (r = 0.205, p = 0.028) and inversely proportional to the degree of deterioration of the quality of life in MLHFQ (r = –0.179, p = 0.049), age (r = –0.429, p = 0.0001), the score on the HADSD scale (r = –0.257, p = 0.004) and the level of ceruloplasmin (r = –0.308, p = 0.004). Conclusions. CD in patients with CHF and decreased LVEF was detected in 85 (68.6 %) cases. CD was associated with the severity of heart failure and the presence of hypertensive disease, coronary heart disease and renal dysfunction. Patients with CHF and CD are statistically significantly older in age, have a worse quality of life and physical activity, a high level of depressive manifestations, a higher concentration of ceruloplasmin in the blood plasma, a lower glomerular filtration rate and a wo
目的-建立与慢性心力衰竭(CHF)和左心室射血分数(LV EF)降低患者认知功能障碍(CD)相关的临床因素。材料和方法。根据纽约心脏协会(NYHA)的标准，我们检查了124例年龄在18至75岁之间的CHF II - IV功能分级患者。认知功能评估采用简易精神状态检查(MMSE)，舒尔特测试，HADS量表。MMSE量表上的点数为26表示存在CD。除了标准的一般临床检查外，还通过MLHFQ(明尼苏达州心力衰竭患者生活问卷)评估生活质量，使用杜克活动状态指数(DASI)计算体力活动指数，6分钟步行测试，免疫分析研究(白细胞介素- 6，脑钠肽n端片段和胰岛素的水平)。用反应性充血样品超声诊断肱动脉内皮血管舒张功能(通量依赖性血管舒张(FDVD))结果和讨论。85例(68.6%)患者出现CD。性别、LVEF值、房颤对认知功能状态的影响无统计学意义。CHF和LVEF降低患者的CD与NYHA最差功能分级(p = 0.001)、高血压、冠心病和肾功能不全(p = 0.037、p = 0.021和p = 0.032)相关。CD患者在统计学上显著(p = 0.002),更糟的生活质量了MLHFQ (p = 0.04)和低便(p = 0.037),高水平的抑郁有规模(p = 0.032),肾小球滤过率降低(p = 0.012),更大的左心室后壁厚度(p = 0.011),劣质FDVD (p = 0.049)相比,患者没有CD。点的数量MMSE量表与6分钟步行的距离直接相关(r = 0.264, p = 0.003),便值(r = 0.275, p = 0.002),肾小球滤过率(r = 0.275, p = 0.002), FDVD (r = 0.207, p = 0.021)和超氧化物歧化酶的活性(r = 0.205, p = 0.028)和恶化的程度成反比的生活质量MLHFQ (r = -0.179, p = 0.049),年龄(r = -0.429, p = 0.0001), HADS-D量表上的得分(r = -0.257, p = 0.004)和血浆铜蓝蛋白的水平(r = -0.308, p = 0.004)。结论。85例(68.6%)CHF合并LVEF降低的患者存在CD。乳糜泻与心力衰竭的严重程度、高血压疾病、冠心病和肾功能不全有关。与没有CD的患者相比，合并CHF和CD的患者年龄更大，生活质量和体力活动更差，抑郁表现水平更高，血浆中铜蓝蛋白浓度更高，肾小球滤过率更低，通量依赖性血管扩张剂反应更差。
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