Clinical and biochemical parameters in patients having coronary heart disease complicated by chronic heart failure with low and preserved ejection fraction
Abstract. The purpose of phenotyping patients with chronic heart failure (CHF) is risk stratification, as well as optimization of treatment of this syndrome, associated with an extremely negative prognosis. Currently, it is relevant the classification of CHF by the ejection fraction (EF) parameter, according to which CHF is distinguished to be with reduced (CHFrEF, ≤ 40%), moderately reduced (CHFmrEF, 41–49%) and preserved EF (CHFpEF, ≥ 50%).Skuratova M.A., Lebedev P.A., Bratchenko I.A., Bratchenko L.A., Lyamin A.V., Kuritsyna A.P., Komarova M.V.
The aim: to identify pathogenetic determinants of CHF phenotypes of ischemic etiology in the conditions of a one-stage cross-sectional study.
Material and methods. The study included 235 patients with CHF of ischemic etiology, functional class II–IV. From them, a combined group (n = 171) with reduced EF regardless of the degree of this reduction (CHFrEF, CHFmrEF) and with CHFpEF (n = 64) was identified. Clinical profile of patients and the levels of laboratory markers in circulating blood were studied, including using the method of enhanced Raman spectroscopy.
Results. Patients with CHFpEF were significantly older: 74.00 ± 8.08 and 69.40 ± 8.94 years, respectively (p = 0.001), with a predominance of females among them (53%). Although the prevalence of arterial hypertension was the same in both groups, the average blood pressure figures were higher in the CHFpEF group. Myocardial infarction was significantly more common in the CHFrEF group – 77.7 versus 43.7% in the CHFpEF group (p = 0.001). With a comparable structure of the severity of CHF syndrome, a lower level of NT-proBNP was observed in the CHFpEF group. Parameters characterizing myocardial damage (troponin I), endothelial dysfunction (P-selectin), and concentration of soluble receptors to advanced glycation end products (S-RAGE) were comparable in the study groups. Serum enhanced Raman spectroscopy (SERS) did not demonstrate its discriminatory ability in identifying patients with different left ventricular EF.
Conclusion. The most significant factor determining CHF phenotype in patients with coronary heart disease is a history of myocardial infarction, which is typical for patients with CHFrEF. Also, in this group, it is worth to note greater inflammatory activity in accordance with the level of leukocytes and alanine aminotransferase. Predominance of females, old age, and elevated blood pressure figures were more typical for patients with CHFpEF.
Keywords
chronic heart failure phenotypes
ischemic heart disease
enhanced Raman spectroscopy
blood biochemical parameters
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About the Authors
Maria A. Skuratova, MD, PhD (Medicine), head of the Department of cardiology, N.I. Pirogov Samara City Clinical Hospital No. 1. Address: 443096, Samara, 80 Polevaya St.E-mail: Skuratova_m@mail.ru
ORCID: https://orcid.org/0000-0002-0703-2764. Scopus ID: 58179741300. eLibrary SPIN: 6774-6215
Pyotr A. Lebedev, MD, Dr. Sci. (Medicine), professor, head of the Department of therapy with a course in functional diagnostics of the Institute of professional education, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya St.
E-mail: palebedev@yahoo.com
ORCID: https://orcid.org/0000-0003-3501-2354. Scopus ID: 57198363733. eLibrary SPIN: 8085-3904
Ivan A. Bratchenko, Dr. Sci. (Physics and Mathematics), professor of the Department of laser and biotechnical systems, Academician S.P. Korolev Samara National Research University. Address: 443086, Samara, 34 Moskovskoe Highway.
E-mail: iabratchenko@gmail.com
ORCID: https://orcid.org/0000-0003-3629-7064. Scopus ID: 22950167200. eLibrary SPIN: 5764-8347
Lyudmila A. Bratchenko, PhD (Physics and Mathematics), associate professor of the Department of laser and biotechnical systems, Academician S.P. Korolev Samara National Research University. Address: 443086, Samara, 34 Moskovskoe Highway.
E-mail: shamina94@inbox.ru
ORCID: https://orcid.org/0000-0003-3781-9274. Scopus ID: 57035297800. eLibrary SPIN: 7889-5907
Artem V. Lyamin, MD, Dr. Sci.(Medicine), associate professor, director of the Scientific and Educational Professional Center for Genetic and Laboratory Technologies, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya St.
E-mail: a.v.lyamin@samsmu.ru
ORCID: https://orcid.org/0000-0002-5905-1895. Scopus ID: 55066363500. eLibrary SPIN: 6607-8990
Anna P. Kuritsyna, MD, specialist at the Scientific and Educational Professional Center for Genetic and Laboratory Technologies, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya St.
E-mail: a.p.kuricyna@samsmu.ru
ORCID: https://orcid.org/0000-0003-2799-7632. Scopus ID: 58755846900. eLibrary SPIN: 3655-3167
Marina V. Komarova, PhD (Biology), associate professor, associate professor of the Department of laser and biotechnical systems, Academician S.P. Korolev Samara National Research University. Address: 443086, Samara, 34 Moskovskoe Highway.
E-mail: marinakom@yandex.ru
ORCID: https://orcid.org/0000-0001-6545-0035. Scopus ID: 56677545100. eLibrary SPIN: 4359-2715
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