GENDER CHARACTERISTICS OF THE COURSE OF CHRONIC HEART FAILURE IN PATIENTS WITH OBESITY AND NORMAL BODY WEIGHT (2024)

Authors

• Kondratyuk M. O.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0001-6707-4029
• Moskva Kh. A.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0003-3366-1975
• Kikhtyak O. P.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0002-1261-1939
• Havrysh Y. I. Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0009-0009-6070-0010
• Sorokopud O. O.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0002-3974-0087
• Besh O. M.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0003-3349-1291
• Leshchuk Y. L.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0002-9214-5762
• Farmaha M. L.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0003-1298-4644
• Sadova-Chuba Z. T.Danylo Halytsky Lviv National Medical University, Lviv, Ukrainehttps://orcid.org/0000-0002-9965-9723

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Abstract

Сardiovascular diseases remain one of the leading causes of morbidity and mortality worldwide. Over the years, the study of various peculiarities of chronic heart failure duration has undergone significant progress; however, gender differences have insufficient coverage in the literature.

Aim: To investigate and conduct a comparative analysis of clinical and laboratory indicators in men and women with chronic heart failure and to determine the factors of an unfavorable prognosis in each group.

Materials and methods. A complete clinical examination of 58 patients (41 (70.6%) men and 17 (29.4%) women) with chronic heart failure was conducted. In addition to standard clinical examinations, body mass index, N-terminal pro-brain natriuretic peptide, and medium mass molecule levels as an indicator of endogenous intoxication were determined. Also, a number of integral hematological indices based on complete blood count parameters were calculated, allowing us to assess the state of non-specific and specific links of immunity, the degree of body intoxication, treatment efficacy, and the state of adaptation processes. The structural and functional parameters of the heart were determined by ultrasound examination. The significance of differences in the compared groups was determined by the Student (t) or Mann-Whitney test. Prediction of the severity of chronic heart failure and survival analysis were performed using the Kaplan-Meier method: the cumulative survival rate after 24 months of follow-up was evaluated with significance assessment using the Gehan-Wilcoxon test and the Cox F-test.

Results. The study found that the number of predictors of a negative prognosis of chronic heart failure in men is much greater than in women. In men, a worse prognosis was associated with anemia, adaptive distress reaction, low and high leukocyte shift index, increased end-diastolic size of the left ventricle, reduced ejection fraction, and manifestations of dyslipidemia. In women, the most significant predictors of a negative prognosis are an increase in endogenous intoxication, a worsening of adaptation processes, and an increase in nonspecific manifestations of inflammation. The conducted study determined the presence of gender differences in the predictors of survival of patients with chronic heart failure, but did not reveal a significant influence of body weight on the studied characteristics. Meanwhile, the role of other parameters related to obesity, namely, proatherogenic components of chronic inflammation, blood coagulation system and dyslipidemia, in the progression and nature of survival of the above-mentioned patients has been proven.

Conclusion: In male patients with chronic heart failure, predictors of a negative prognosis indicate cardiac remodeling, namely, dilatation of the chamber cavity of the left ventricle and reduction of the ejection fraction, and changes in the blood lipid profile associated with obesity. In women with chronic heart failure, the most significant predictors of a negative prognosis are the severity of the pathology and indicators of stress-reactive metabolism.

References