ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2016, 1(1): 33–36
https://doi.org/10.26693/jmbs01.01.033
Medicine

Current Predictors of Survival and Methods of their Correction in Patients with Chronic Heart Failure in Medical Practice

Buchko O.Yu.
Abstract

Chronic heart failure (CHF) is an important problem of modern cardiology, a clinical syndrome, determines the course and prognosis of most cardiovascular disease is manifested by shortness of breath at rest or on exertion, fluid retention, structural or functional alteration of the heart. According to the national registers and epidemiological studies of various European countries, the prevalence of heart failure in the adult population ranges from 1,5 to 5,5% and increases with the age, and those over 70 years - is 15%. We know that informative clinical and demographic predictors of poor quality of life in patients with CHF is smoking, myocardial infarction, presence of chronic obstructive pulmonary disease, increased indices of left ventricular end-volume>155 ml / m², III-IV FC by NYHA, hypercreatynemia, hyponatriyemia, night apnea. Тo the recommendations of the Association of Cardiologists of Ukraine on the diagnosis, treatment and prevention of heart failure (2012), in the case of NT-proBNP in untreated patients 2000 pg / ml is a high probability of having heart failure and the risk of dangerous complications and death increases considerably at levels> 1000 pg / ml. It turned out that halektyn-3 is an independent predictor of worsening heart failure prognosis, increase its content of over 17.8 ng / mL, was associated with a higher risk of adverse events, including death and hospitalization. We study the role of nitric oxide, as the main pathogenetic factors of endothelial dysfunction in patients with CHF is to reduce the bioavailability of nitric oxide (NO) and increased endothelin-1, which has a strong vasoconstrictor action is inhibition of the expression of endothelial NO-synthase (eNOS) and changing the tumor necrosis factor α, which depends on the clinical severity of heart failure indicate patient prognosis. At present the algorithm of patients with heart failure and left ventricular systolic dysfunction, based on data from evidence-based medicine. Pharmacological agents can be divided into symptomatic and that improve the survival of patients. The first improves hemodynamics and clinical status of patients, although their ability to improve long-weather survival is not proven (thiazides, cardiac glycosides). The second block at different levels of neurohormonal activity of key systems responsible for the progression of CHF and help to increase the life expectancy of patients. Today, when all patients receive standard treatment to increase life expectancy, the problem remains acute improve their quality of life. Therefore, it is important to determine predictors of prognosis of CHF, because their modification gives the potential to increase the chances of life of these patients. Predictors of bold, be looking for further improvement algorithm individual prognosis and treatment policy in сhronic heart failure.

Keywords: heart failure, predictors, nutriuretic peptide, galectin-3, treatment

Full text: PDF (Ukr) 109K

References
  1. Voronkov LG, Bagriy AE, Amosova KM. Rekomendatsiyi z diagnostiki ta likuvannya hronichnoyi sertsevoyi nedostatnosti. Kyiv: Zdorov'ya, 2012. 36 s.
  2. Voronkov LG, Babich PM, Lutsak OO, Lyashenko AV. Prediktori yakosti zhittya u hvorih z hronichnoyu sertsevoyu nedostatnIstyu. Ukrainskiy medichniy chasopis. 2012; 3: 23–5.
  3. Voronkov LG, Yanovskiy GV, Ustimenko OV, i dr. Serdechnaya nedostatochnost. Ukrainskiy kardIologIchniy zhurnal. 2003; 5: 84-7
  4. Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, Witteman JC, Stricker BH. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime and prognosis of heart failure. Eur Heart J. 2004; 36: 1614–9. https://doi.org/10.1016/j.ehj.2004.06.038
  5. Christenson RH, Duh SH, Wu AH, Smith A, Abel G, deFilippi CR, Wang S, Adourian A, Adiletto C, Gardiner P. Multi-center determination of galectin-3 assay performance characteristics: anatomy of a novel assay for use in heart failure. Clinic Biochemy. 2010; 43: 683–90. https://doi.org/10.1016/j.clinbiochem.2010.02.001
  6. De Filippi CR. Galectin-3 in heart failure – linking fibrosis, remodeling, and progression. US Cardiology. 2010; 7: 67–70.
  7. Dell'Omo G, Penno G, Pucci L, Fotino C, Lucchesi D, Del Prato S, Pedrinelli R. Lack of association between endothelial nitric oxide synthase gene polymorphisms, microalbuminuria and endothelial dysfunction in hypertensive men. J Hypertens.2007; 25 (7): 1389–95. https://doi.org/10.1097/HJH.0b013e3281268548
  8. Grodzicki T, Łukasik Fedyk, Dubiel JS, et al. Niewydolność serca u osób w wieku podeszłym. Gdańsk; 2004. 203 с.
  9. Habota T, McLennan SN, Cameron J, et al. сProspective Memory Impairment in Chronic Heart Failure. Journal of the International Neuropsychological Society. 2015; 21: 183–92. https://doi.org/10.1017/S1355617715000119
  10. Iwanaga Y, Miyazaki S. Heart failure, chronic kidney disease and biomarkers – an integrated viewpoint. Circ J. 2010; 74 (7): 1274–82. https://www.ncbi.nlm.nih.gov/pubmed/20558890
  11. McDonagh TA, Cunningham AD, Morrison CD, J McMurray, I Ford, J Morton, H Dargie. Left ventricular dysfunction, natriuretic peptides and mortality in an urban population. Heart. 2012; 83: 347-9. https://doi.org/10.1136/heart.86.1.21
  12. Nessler J, Skrzypek A. Przewlekła niewydolność serca u osób w podeszłym wieku – aktualny problem medyczny. Pol Archiwum medycunu wewnetrznej. 2008; 118: 234–7.
  13. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, Tavazzi L, Smiseth OA, Gavazzi A, Haverich A, Hoes A, Jaarsma T, Korewicki J, Lévy S, Linde C, Lopez-Sendon JL, Nieminen MS, Piérard L, Remme WJ. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary: The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J. 2005; 26: 1115–40. https://doi.org/10.1093/eurheartj/ehi204
  14. Troughton RW, Frampton CM, Yandle TG, Espiner EA, Nicholls MG, Richards AM. Treatment of heart failure guided by plasma aminoterminal brain nutriuretic: peptide guided concentrations. Lancet. 2010; 335: 1126–30. https://www.ncbi.nlm.nih.gov/pubmed/10791374
  15. Wendelboe NO, Kirk V, Bay M, Boesgaard S, Nielsen H. Value of N terminal probrain natriuretic peptide in the elderly. Eur J Heart Fail. 2004; 6: 275¬-9. https://doi.org//10.1016/j.ejheart.2003.12.010