Влияют ли возраст и пол на фенотип хронической сердечной недостаточности?

Abstract

The increase in life expectancy of the Russian population is accompanied by a tendency of aging of patients with coronary heart disease (CHD) and chronic heart failure (CHF). Attention is paid to gender differences in the contributions of individual characteristics to the formation of the heart failure clinical phenotype. The purpose to determine the features of the clinical picture of chronic heart failure in patients with coronary heart disease, taking into account gender and age. Material and methods. 517 patients with CHF and coronary heart disease of both genders were examined. A comparison was made of clinical, laboratory, and instrumental parameters of patients with CHF of different age periods, males and females. Results. Until the age of 60, CHF was predominantly observed in men, in the group older than 75 years in women (p < 0.001). With increasing age, the proportion of nicotine dependent patients decreased, as well as the value of the metabolic index and exercise tolerance. In older patients with CHF, the levels of hemoglobin and triglycerides (TG) in blood decreased. The inverse correlation was found between age and left ventricular ejection fraction (LVEF) and LV end-diastolic size. Among men, tobacco smoking (p = 0.001) and chronic obstructive pulmonary disease (p = 0.001) were found more often. In women, CHF was combined with diabetes mellitus (p < 0.001) and chronic kidney disease (p = 0.001). Female patients differed in levels of general cholesterol, triglyceride and non-high fraction blood cholesterol (p = 0.001, p = 0.023, p = 0.009). Men had more creatinine (p = 0.001) and blood uric acid (p = 0.014). Conclusions. The study identified heart failure with preserved LVEF in 61.5% of men and 74.6% of women; CHF with moderately reduced LVEF — in 15.9% and 18.3%, and CHF with reduced LVEF — in 20.2% and 9.5% (p = 0.003), respectively.