Individual prognosis of complications in the presence of chronic heart failure

Abstract

Neurohumoral theory of chronic heart failure (CHF) development, approved by most scientists, does not completely explain mechanisms of its decompensation. Standard treatment is not always effective, thus, search for pathogenetic and prognostic factors, which influence the course of CHF, remains a current issue. However, individual prognosis of CHF course in clinical practice is not performed at present, since its distinct criteria have not been specified. Thus, it became the expediency and rationale of our research, the aim of which was to assess individual risk of occurrence of complications in patients with CHF, considering a combined influence of several factors. A complete clinical examination of 110 patients (74.5 % males, 25.5 % females) with CHF has been performed. The method of logistic regression was used for determination of combined influence of analyzed factors on CHF prognosis; adequacy and reliability of the difference of the obtained model were investigated by Wald’s criteria and chi-square test. On elaboration of the prognosis method of individual risk of the development of cardiac insufficiency, among other factors that, according to literature data, influence the development of the disease, we have singled out three factors, which have a reliable (P < 0.05) association with CHF: BMI, total cholesterol and amount of lymphocytes. Elaborated computer program, which can calculate the prognosis of CHF complications. This file opens in the program “Microsoft Excel” calculates individual risk and graphically demonstrates the degree of risk. Conducted correlation analysis of individual risk of CHF complications showed that its likelihood is accompanied by development of systolic dysfunction, hypertrophy of the left ventricle with dilatation, anemic and detoxification syndromes, impairment of liver and kidney functions with the reduction of leptin in the blood, which has important regulative functions. Thus, based on conducted logistic, correlation and prognostic analyses, individual risk of the development of CHF complications increases under conditions of combined factors, such as weight loss, decrease in total cholesterol level and reduction of the content of peripheral blood lymphocytes. Application of elaborated computer program allows a doctor to calculate individual risk and visualize it.