Comparative conformity of Russian and international criteria for identifying pre-stages of heart failure in coronary artery disease patients: A cross cohort study
Introduction. Currently, there is no unified approach to phenotyping pre-stages of heart failure (HF) in patients with coronary artery disease (CAD).A.A. Abramov, T.M. Timofeeva, V.V. Tolkacheva, I.S. Nazarov, Zh.D. Kobalava
Objective: To study the types of pre-HF stages identified using traditional echocardiographic (EchoCG) parameters and biomarkers, depending on the guidelines used, and to identify consistent and inconsistent positions.
Material and methods. 151 patient with verified coronary artery disease (69% men, mean age 64.3 ± 8.21 years) without HF, dyspnea, or other HF symptoms was included in the study. All patients underwent standard physical, laboratory, and instrumental examinations, including lung ultrasound examination, NT-proBNP and troponin levels measurements, and cardiac structural and functional estimation.
Results. The detection rate of HF pre-stage according to the Russian Society of Cardiology (RSC, 2024) criteria was 94%, while according to the American heart association (AHA, 2022) criteria, it was 98.3%. Five echocardiographic markers of pre-HF according to the RSC and AHA recommendations are completely corresponding and allow to identify the same patients. Three criteria of these societies are similar but do not coincide due to differences in diagnostic parameters. Six additional echocardiographic criteria for pre-onset HF, also considered in the study, are contained only in the AHA guidelines. Structural remodeling domain made the primary contribution to the diagnosis of this condition, identifying 24 (15.9%) patients with pre-onset HF according to RSC criteria and 13 (8.6%) according to AHA criteria. The systolic domain (GLS) allowed for the additional identification of 6 (4.0%) patients according to RSC criteria and 2 (1.3%) according to AHA criteria. Left atrial strain (LASr) deformation assessment further verified 3 (2.0%) cases of pre-onset HF according to RSC criteria and 1 (0.7%) according to AHA criteria, while biomarker measurements confirmed 6 (4%) and 0 cases, respectively.
Conclusion. For patients with ischemic heart disease without HF symptoms, Russian and international criteria for identifying pre-onset HF are incompletely consistent. Myocardial deformation parameters not fully included in the current criteria allow for the additional identification of 0.7 to 4.0% of patients with pre-stage HF with normal ejection fraction values, giving reasons for their inclusion in the diagnostic algorithm.
Keywords
heart failure
pre-stage heart failure
coronary artery disease
myocardial deformation parameters
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About the Authors
Alexey A. Abramov, MD, postgraduate student of the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseyev of the Institute of clinical medicine of the Medical institute, RUDN University, Moscow, Russian Federation.E-mail: aaabramov196@mail.ru
ORCID: https://orcid.org/0000-0002-9678-5871. eLibrary SPIN: 6915-3717
Tatiana M. Timofeeva, MD, PhD (Medicine), associate professor of the Department of internal medicine with a course in cardiology and functional diagnostics named after Academician V.S. Moiseyev of the Institute of clinical medicine of the Medical institute, RUDN University, Moscow, Russian Federation.
E-mail: timtan@bk.ru
ORCID: https://orcid.org 0000-0001-6586-7404. Scopus ID: 58021004300. eLibrary SPIN: 9502-8786
Veronika V. Tolkacheva, MD, Dr. Sci. (Medicine), professor of the Department of internal medicine with a course in cardiology and functional diagnostics named after Academician V.S. Moiseyev of the Institute of clinical medicine of the Medical institute, RUDN University, Moscow, Russian Federation.
E-mail: tolkachevav@mail.ru
ORCID: https://orcid.org//0000-0001-6847-8797. Scopus ID: 8307379200. eLibrary SPIN:
Ivan S. Nazarov, MD, PhD (Medicine), assistant at the Department of internal medicine with a course in cardiology and functional diagnostics named after Academician V.S. Moiseev of the Institute of clinical medicine of the Medical institute, RUDN University, Moscow, Russian Federation.
E-mail: nazarovradomla@mail.ru
ORCID: https://orcid.org/0000-0002-0950-7487. Scopus ID: 57686928900. eLibrary SPIN: 5954-7828
Zhanna D. Kobalava, MD, Dr. Sci. (Medicine), professor, corresponding member of RAS, head of the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseev of the Institute of clinical medicine of the Medical institute, RUDN University, Moscow, Russian Federation.
E-mail: zkobalava@mail.ru
ORCID: https://orcid.org/0000-0002-5873-1768. Scopus ID: 7004399203. eLibrary SPIN: 9828-5409
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