scholarly journals Features of the Functional Status and Cytokine Profile of Patients with Chronic Heart Failure in Combination with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 11 (1) ◽  
pp. 9-13
Author(s):  
Roman Tokmachev ◽  
Andrey Kravchenko ◽  
Andrey Budnevsky ◽  
Evgeniy Ovsyannikov ◽  
Evgeniy Tokmachev ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Functional Status ◽  
Serum Levels ◽  
Cytokine Profile ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Group 2 ◽  
Hs Crp ◽  
Group 1

The purpose of this research was to study the effect of COPD on the functional status and cytokine profile of patients with chronic heart failure (CHF) with different ejection fraction (EF). Methods and Results: The study involved 240 patients diagnosed with CHF (mean age of 72.4±8.7 years). Among them, 80 patients were diagnosed with CHF and COPD. Depending on the presence of COPD, the patients were divided into two groups: Group 1 included 160 patients with CHF without COPD; Group 2 included CHF 80 patients with COPD. According to the value of LVEF, each of the two groups was divided into two more subgroups: In Group 1, CHFpEF (EF≥50%) was recorded in 69 patients (Subgroup 1) and CHFrFV (EF<50%) in 91 patients (Subgroup 2). In Group 2, CHFpEF was observed in 36 patients (Subgroup 3) and CHFrEF in 44 patients (Subgroup 4). The 6-minute walk distance (6MWD) was measured in meters and compared with the proper 6MWD(i). All patients included in the study underwent the Borg test to assess dyspnea after 6MWT. The serum levels of NT-proBNP, hs-CRP, IL-1β, IL-6, and TNF-α were determined using an automatic analyzer IMMULITE 2000 (Siemens Diagnostics, USA) and quantitative ELISA kits. The patients with CHFpEF had higher levels of hs-CRP, pro-inflammatory cytokines than patients with CHFrEF. The combination of COPD and CHF amplifies systemic inflammation (hs-CRP, proinflammatory cytokines) and myocardial remodeling processes (NT-proBNP) in comparison with the isolated course of CHF. COPD negatively affects the functional status of patients with CHF with different EF by lower values of 6MWD, 6MWD/6MWD(i) ratio, and higher results on the Borg dyspnea test.

scholarly journals Diagnosis of chronic heart failure in patients with chronic obstructive pulmonary disease

2019 ◽  
Vol 100 (3) ◽  
pp. 530-536
Author(s):  
V I Koliev ◽  
I E Sarapulova ◽  
L V Ryabova
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Linear Dimensions ◽  
The Right ◽  
Group 1

Aim. To identify methods for diagnosing early signs of heart failure in patients with chronic obstructive pulmonary disease. Methods. We examined 54 patients with chronic obstructive pulmonary disease without exacerbation. Patients were divided into two groups: group 1 - 26 patients with chronic obstructive pulmonary disease in combination with chronic heart failure; group 2 - 28 patients with chronic obstructive pulmonary disease without chronic heart failure. The groups were comparable by age and severity of chronic obstructive pulmonary disease. Electrocardiography, echocardiography were performed with additional determination of the right heart chamber parameters, spirometry, X-ray, pulse oximetry. The level of highly sensitive C-reactive protein, blood acid-base composition and brain natriuretic peptide was evaluated. Results. Patients with comorbidity have decreased exercise tolerance according to the 6-minute walk test and mMRS scale, higher body mass index and dyspnea intensity, larger linear dimensions of the heart chambers and their volume parameters. Heart failure with preserved ejection fraction was observed in 21 (80%) of patients in group 1, therefore, the signs of heart failure can be explained by diastolic dysfunction of the right and left ventricles. Among patients with chronic obstructive pulmonary disease and chronic heart failure in our study, extended linear dimensions and structural changes in the ventricles, indicating pre- and postcapillary hypertension, were significantly more common. Conclusion. The use of tissue Doppler study allows more accurately determining the diastolic function of the right and left ventricles; the brain natriuretic peptide study is a sensitive marker of early forms of diastolic chronic heart failure.

scholarly journals Value of biomarkers in the diagnosis of community-acquired pneumonia with concomitant chronic heart failure: a prospective observation study.

2020 ◽  
Author(s):  
Svetlana Rachina ◽  
Andrey Bobylev ◽  
Sergey Avdeev ◽  
Roman Kozlov ◽  
Pavel Lazarev ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Serum Levels ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Observation Study ◽  
Reactive Protein ◽  
Group 2 ◽  
Factor Α ◽  
Group 1

Abstract Background The diagnosis of community-acquired pneumonia (CAP) in patients with chronic heart failure (CHF) is associated with objective difficulties due to similar clinical presentation. We aimed to evaluate the utility of serum biomarkers - С-reactive protein (CRP), procalcitonin (PCT), tumour necrosis factor α (TNFα), interleukin-6 (IL-6) and brain natriuretic peptide (BNP) in diagnosis of CAP in the presence of СHF.Methods Prospective observational study included patients with previously diagnosed CHF and suspected non-severe CAP. Participants underwent routine procedures and chest multispiral computed tomography (MSCT); serum levels of biomarkers (CRP, PCT, TNFα, IL-6) and BNP were measured. All patients were divided into group 1 with confirmed CAP and group 2 with excluded CAP according to MSCT findings. Standard statistical tools were applied, p-value <0.05 in two-tailed tests was considered statistically significant. The value of biomarkers was determined using logistic regression, their discriminatory efficacy was assessed by analyzing Receiver Operation Characteristic (ROC) curves.Results Altogether 35 with CAP (median age 78 (64-82) years, female 24/35 (68.6%)) and 35 - without CAP (median age 77 (71-82) years, female 22/35 (62.9%)) were enrolled. There were no differences between groups in baseline characteristics, with the exception of body temperature. We found significantly higher levels of CRP 50.0 (35.5-98.5) mg/L, PCT 0.10 (0.05-0.54) ng/mL and IL-6 46.1 (21.4-150.3) pg/mL in group 1 as compared to group 2 - 15.0 (9.5-25.0) mg/L, 0.05 (0.05-0.05) ng/mL and 13,6 (9,5; 25,0) pg/mL, respectively. AUC (95% CI) was the highest for CRP – 0.91 (0.83-0.98), followed by PCT – 0.81 (0.72-0.90) and IL-6 – 0.81 (0.71-0.91). CRP value of 28.5 mg/L had optimal sensitivity and specificity ratio (85.7/91.4%).Conclusion The measurement of serum CRP, PCT, IL-6 levels can be useful for diagnostics of CAP in patients with concomitant CHF. CRP had the optimal diagnostic utility in this population. Key words: community-acquired pneumonia, chronic heart failure, inflammatory biomarkers

scholarly journals Prognostic role of ST2 in patients with chronic heart failure of ischemic etiology and carbohydrate metabolism disorders

2019 ◽  
Vol 91 (1) ◽  
pp. 32-37 ◽  
Author(s):  
E V Grakova ◽  
K V Kopeva ◽  
A T Teplyakov ◽  
O N Ogurkova ◽  
A A Garganeeva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Carbohydrate Metabolism ◽  
Serum Levels ◽  
Left Ventricular ◽  
Type 2 Dm ◽  
Group 2 ◽  
Group 1

Aim. To study the role of soluble ST2 (sST2) in patients with coronary artery disease (CAD) and chronic heart failure (CHF) associated with carbohydrate metabolism disorders (impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) in risk stratification of adverse cardiovascular events (ACE) for 12 months of follow-up. Materials and methods. We enrolled 118 patients with CAD and CHF I-III FC (NYHA) with the ejection fraction of left ventricular of 60 [46; 64] % aged 62.5 [57; 68] years. Serum sST2 levels were measured by enzyme immunoassay. Results. Depending on the presence of carbohydrate metabolism disorders (CMD), the patients were divided into 3 groups: group 1 (n=65) included patients without CDM, group 2 (n=30) included with IGT, and group 3 (n=23) included with type 2 DM. Serum levels of sST2 in patients with CMD were significantly (p=0.011) higher than in patients without CMD, but in subgroups of patients with IGT and type 2 DM, the concentrations of sST2 did not differ. In group 1 sST2 levels were 30.51 [26.38; 37.06] ng/ml, and in group 2 and 3 - 37.97 [33.18; 47.48] and 41.45 [35.27; 50.37] ng/ml, respectively. There were statistically significant differences in the rate of adverse ACE in relation to sST2 levels: in spite of CMD, in subgroups with biomarker overexpression adverse CCC occurred more often (p

scholarly journals Comorbidities of Primary Care patients with COVID-19 during the first wave of the SARS-CoV-2 pandemic in the Community of Madrid

2021 ◽  
Author(s):  
José-Luis Puerta ◽  
Macarena Torrego-Ellacuría ◽  
Ángel Del Rey-Mejías ◽  
César Biénzobas López
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
High Blood Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Group 2 ◽  
Group 1

Objectives. Recent publications on inpatients with COVID-19 describing their comorbidities and demographic profile exists, but data from large populations requiring only primary care (PC) are scarce. This paper aims to fill this gap and report the prevalence of eight comorbidities (high blood pressure, diabetes mellitus, cancer, cardiovascular disease, asthma, chronic kidney disease, chronic obstructive pulmonary disease, and chronic heart failure) among patients attending PC during the onset of the SARS-CoV-2 pandemic in the Community of Madrid (CoM), Spain. Patients and methods. This is an observational retrospective study that collects data registered in the CoM between February 25th and May 31st, 2020. Data are divided in two groups: Group-1 (N=339,890) consist of all patients with suspected or proven SARS-CoV-2 infection; and Group-2 is the subgroup (N=48,556, 14.3% of Group-1) of individuals with COVID-19 confirmed by positive RT-PCR test. Results. Comparing Group-1 with Group-2, 339,890/48,556 patients, respectively, the main results were as follows: average age (60.9/69.9 years), presence of at least one comorbidity (33.51%/47.69%), high blood pressure (19.74%/32.74%), diabetes mellitus (7.13%/13.75%), cancer (6.56%/10.6%), cardiovascular disease (4.52%/9.26%), asthma (7.98%/6.56%), chronic kidney disease (1.84%/4.41%), chronic obstructive pulmonary disease (2%/4.03%), and chronic heart failure (1.14%/2.77%). High blood pressure and diabetes mellitus were seen to be the most frequent (6.56%/8.38%) association. Conclusions. Patients requiring PC attention during the first wave of the COVID-19 pandemic in the CoM presented with a very high rate of comorbidities, with marked differences among those with or without a confirmed SARS-CoV-2 infection.

Angiotensin-converting enzyme inhibition restores the diffusing capacity for carbon monoxide in patients with chronic heart failure by improving the molecular diffusion across the alveolar capillary membrane

1999 ◽  
Vol 96 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Marco GUAZZI ◽  
Piergiuseppe AGOSTONI
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibition ◽  
Angiotensin Converting Enzyme Inhibition ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibition ◽  
Group 2 ◽  
Alveolar Capillary ◽  
Group 1

Conductance of alveolar capillary membrane (DM) and capillary blood volume (VC) are the subcomponents of the pulmonary diffusing capacity for carbon monoxide (DLco). In chronic heart failure, stress failure of the membrane provides a mechanism for reduced DM and subsequent impairment of DLco. Angiotensin-converting enzyme inhibition improves DLco in patients with chronic heart failure. This study was aimed at investigating which of the two subcomponents of DLco is affected by angiotensin-converting enzyme inhibitors. Twenty-seven patients with NYHA class II to III chronic heart failure (group 1) and 13 age- and sex-matched normal subjects underwent pulmonary function testing with determination of DM and VC, while receiving placebo and 48 ;h and 1 and 2 months after starting enalapril treatment (10 ;mg twice daily). Nine similar patients (group 2) received isosorbide dinitrate (40 ;mg thrice daily) for a month then enalapril for another month, and underwent pulmonary function testing at 48 ;h and 1 month after starting treatments. Effects of angiotensin-converting enzyme inhibition in normal controls were not significant in the short- or mid-term. In group 1 patients, the only change observed at 48 ;h was a reduction in VC (probably due to a decrease in capillary pulmonary pressure). There was a marked increase in DM to a similar extent at 1 and 2 months, resulting in a significant improvement in DLco despite a decrease in VC. In group 2 patients, nitrates failed to improve DLco and DM, whereas enalapril was as effective as in group 1. These observations suggest a modulatory effect of angiotensin-converting enzyme inhibition on the membrane function which emerges gradually and persists over time and is probably dissociated from changes in pulmonary capillary pressure and VC. Chronic heart failure disturbs the alveolar capillary interface and increases gas diffusion resistance; angiotensin-converting enzyme inhibition restores the diffusive properties of the membrane and gas transfer, and protects the lung when the heart is failing.

scholarly journals The risk of developing chronic heart failure in patients with hypertension depending on the actual arterial stiffness

2020 ◽  
Vol 35 (2) ◽  
pp. 98-105
Author(s):  
A. I. Chernyavina ◽  
N. A. Koziolova
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Stiffness ◽  
Left Ventricular ◽  
Myocardial Mass ◽  
Developing Heart ◽  
Group 2 ◽  
Lv Volume ◽  
Lv Diastolic Function ◽  
Group 1

Objective. To determine the risk of developing chronic heart failure (CHF) in patients with hypertension (HTN) depending on the actual arterial stiffness.Material and Methods. The study included 175 patients with HTN without a verified diagnosis of heart failure. The average age was 48.5 ± 6.8 years. Patients underwent general clinical examination, volume sphygmoplethysmography assessments of cardio-ankle vascular index (CAVI), echocardiography study (left ventricular (LV) ejection fraction, LV diastolic function, LV myocardial mass index, indexed LV volume by echocardiography), and tests for serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). Patients were divided into two groups depending on CAVI. Group 1 included 141 (80.6%) patients with CAVI < 9; group 2 included 34 (19.4%) patients with CAVI > 9.Results. In patients of group 1, the level of NT-proBNP was 0.008 [0.006; 5.770], which was significantly lower than the corresponding value in group 2, where the level of NT-proBNP was 13.08 [0.01; 350.65] ng/mL (p = 0.041). Indicators of odds ratio (OR) and relative risk (RR) were also significant. The chance of developing CHF with CAVI > 9 increased by almost 7 times (OR = 6.9; 95% CI = 2.8–16.8), and OR of CHF onset was 4.1 (95% CI = 2.2–7.6). Sensitivity and specificity rates were 55.9% and 84.4%, respectively. Correlation analysis revealed a medium degree of dependence and direct relationships between NT-proBNP level and CAVI values (r = 0.35; p <0.05).Conclusion. Serum level of NT-proBNP depended on the actual arterial stiffness. Patients with CAVI > 9 indicative of an increase in true arterial stiffness had a greater risk of developing heart failure assessed based on the level of NT-proBNP in the blood. Further studies are required to assess the effects of arterial stiffness, registered within the intermediate values of CAVI index, on the risk of heart failure onset. 

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