Поражение печени при хронической сердечной недостаточности

Abstract

Non-alcoholic fatty liver disease (NAFLD) and chronic heart failure (CHF) are characterized by a high and constantly increasing prevalence. Hepatocardial relationships in patients with CHF are based on impaired blood supply and hypoxia. The purpose — to investigate liver damage in patients with CHF using the HSI index. Material and methods. 348 patients with stable CHF in the compensation stage, aged 66.4 (10.4) years, were examined. Liver damage was assessed by the HSI index. Results and conclusions. NAFLD was detected in 54.3% of patients with CHF. The proportion of people with NAFLD decreased with increasing age: 62.8% in the group of < 60 years, 53.6% — 60–75 years, 45.1% — > 75 years. Patients with CHF and NAFLD were more often female (p = 0.002), younger (p = 0.001), with burdened heredity for cardiovascular diseases (p = 0.010), with type 2 diabetes mellitus (p < 0.001). The proportion of patients with CHF IV FC was higher in the presence of NAFLD (p = 0.03). Patients with NAFLD had higher body mass index (BMI) (p<0.001) and metabolic index (p < 0.001). Obesity of 1–3 degrees was more often in patients with NAFLD than without liver damage (p < 0.001). The mass of the left ventricular myocardium (MMLF) in male and female patients with CHF was higher in the presence of NAFLD, compared with patients without NAFLD (p = 0.004 and p = 0.001). A comparison of blood parameters in patients with CHF and NAFLD demonstrated a higher level of glucose (p < 0.001), alanine aminotransferases (ALT) (p < 0.001), uric acid (p = 0.013), total protein (p = 0.013), highly sensitive C-reactive protein (hs-CRP) (p = 0.012) and triglycerides (TG) (p < 0.001). Correlations of HSI with age, BMI, metabolic index, glucose levels, ALT, uric acid, total protein, hs-CRP, total cholesterol, triglycerides, and MMLF were revealed.