Diagnosis Of Chronic Heart Failure Research Articles

INFLUENCE OF LGALS-3 GENE POLYMORPHISM (rs2274273) ON THE PLASMA LEVELS OF GALECTIN-3 IN WOMEN WITH ESSENTIAL HYPERTENSION AND CHRONIC HEART FAILURE IN RESIDENTS OF THE PODILLYA REGION OF UKRAINE

Background. Individual genetic features can influence to formation of structural and functional changes in organs during EH and encourage the search for biological markers of the state of the myocardium and conclusions about their diagnostic effectiveness.
 Aim: to improve the early diagnosis of changes in the structure and function of the myocardium and the formation of prerequisites for chronic heart failure (CHF) in women with EH carriers of various polymorphic variants of the LGALS-3 gene (rs2274273), based on galectin-3 plasma level.
 Materials and methods. 180 postmenopausal women, average age 57,34±0,45, residents of the Podillya region of Ukraine were examined. The main group included 113 women with EH, of which 62 people had EH II, 51 people - EH with CHF C stage according to the ESH 2023 classification. The control group included 67 women without signs of cardiovascular pathology. In addition to the general clinical examination, the research used the enzyme immunoassay method to determine the level of galectin-3 in blood plasma, genotyping of the LGALS3 gene (rs2274273) by means of polymerase chain reaction, and ultrasound of the heart. The statistical processing of the obtained results was carried out using the package of statistical programs SPSS, STATISTICA v. 10.0. Using the MedCalc Software Ltd. Odds ratio calculator (https://www.medcalc.org/calc/odds_ratio.php) the conformity of the frequency distribution of genotypes in the studied population to the Hardy-Weinberg equilibrium was checked and calculated the odds ratio (OR) of the development of left ventricular myocardial hypertrophy (LVH) and CHF on the background of EH. The threshold levels of galectin-3 in blood plasma for the diagnosis of LVH and CHF were calculated using the ROC analysis method.
 Results. During study the frequency distribution of genotype variants of the galectin-3 gene (rs2274273) among women residents of the Podillya region of Ukraine, it was found that both in people without cardiovascular pathology and in patients with EH II and EH III, the GA genotype predominates, although there is a significant difference between the frequency of occurrence genotypes GA and GG are not noted (p>0.05). The AA genotype variant is significantly less frequent than both the GA and GG genotypes (p<0.01). The frequency distribution of genotype variants corresponds to the Hardy-Weinberg equilibrium. Moreover, the ratio between genotypes in patients of different stages of EH does not reliably differ from that in the control group. However, in EH complicated by CHF among patients with LVEF < 50% A allele carriers significantly predominate compared to GG homozygotes (79.31%, n=23 vs. 20.69%, n=6). In patients with EH, it was found that the concentration of galectin-3 in blood plasma in carriers of the A allele is significantly higher than in carriers of the GG genotype: EH without CHF - 16.82±0.54 ng/ml vs. 12.82±0.54 ng/ml (p<0.01); EH with CHF – 35.70±1.53 ng/ml vs. 25.39±1.38 ng/ml (p<0.001). The threshold levels of galectin-3 plasma concentrations, which indicate the presence of LVH and CHF, are significantly higher in carriers of the A allele than in carriers of the GG genotype.
 Conclusion. The carriers of the A allele of the LGALS3 gene (rs2274273) have a greater chance of developing CHF with a LVEF < 50% (OR 4.60; 95% CI 1.35 - 15.73 z statistic 2.43 p<0.01 χ2=6 .28; p=0.0122) and correspondingly higher levels of galectin-3 in blood plasma compared to carriers of the GG genotype.

Development of remote person-centred care based on participatory design for people with chronic obstructive pulmonary disease and chronic heart failure -A Randomized Controlled trial.

Background: Person-centred care (PCC) is an approach based on ethical principles. To support operationalization of person-centred ethics in clinical practice a framework was developed by the Gothenburg Centre for Person Centred Care (GPCC). Both chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are known for their high mortality and severe impact on activities in daily living. Therefore, self-management strategies are crucial to optimize care. Digital solutions have been suggested as a safe option to promote self-management of chronic conditions such as COPD and CHF. However, most digital solutions seem to be lacking the user-perspective in the development of the platform. The project aimed to develop and evaluate a remote PCC based on a participatory design for people with chronic obstructive pulmonary disease and chronic heart failure.
 Method: Public involvement is a cornerstone in PCC. Therefore, this study incorporates a participatory design that assumes that all users; patients, relatives and healthcare professionals (HCPs) are involved in the study design and development of the intervention (remote PCC). Extensive iterative consultations with the users took place during the development and design of the digital platform (7). An advisory group consisting of patient representatives, relatives, HCPs, system-developers and researchers was formed to provide advice and co-design all of the major elements of the study design. This study was a multicenter randomized trial conducted from 2018 through 2020. In total, 222 patients were recruited from nine primary care centers. Patients with a diagnosis of COPD and CHF were eligible. Participants were randomized into either usual care (n=112) or PCC on top of usual care (n=110). The primary endpoint was a composite score of change in general self-efficacy (GSE) and hospitalization or death 6 months after randomization, which was dichotomized into improved and deteriorated/unchanged. In addition, data from the 3-month follow-up were analyzed and a per-protocol analysis of those participants that used the intervention were conducted.
 Results: The patient representatives suggested that the platform should include functionalities such as the possibility of a two-way communication and reliable user-friendly information about their condition. The HCPs contributed with input concerning layout and technical functionalities. The effect study showed no significant between-group differences in the composite score at the 3- and 6 months follow-ups. There was, however, a significant difference between the study groups in the per-protocol analysis at three months (p=0.047). This effect was driven by a change in General Self Efficacy from baseline.
 Conclusion: The participatory designed remote PCC resulted in a generic digital platform in this study, the end-user input in the development process is probably mirrored in the increase in self-efficacy among those that used the platform. PCC by a combined digital platform and structured telephone support seems to be a safe option to support people with CHF and COPD to increase their self-efficacy. This study adds to the knowledge of involving users in the design and development process of interventions. Further research is needed in order to explore how to tailor different components in digital interventions and PCC to each unique patient.

Pharmacological research progress of five classical prescriptions in treatment of chronic heart failure

Chronic heart failure(CHF) is a comprehensive clinical syndrome caused by multiple factors that result in structural and/or functional abnormalities of the heart, leading to impaired ventricular contraction and/or relaxation functions. This medical condition represents the final stage of various cardiovascular diseases. In the treatment of CHF, multiple clinical studies have demonstrated the benefits of using traditional Chinese medicine(TCM) to control oxidative stress, inflammation, and apoptosis, thereby delaying ventricular remodeling and reducing myocardial fibrosis. In this study, common TCM syndromes in the diagnosis and treatment of CHF in recent years were reviewed and summarized. Five common treatment methods including benefiting Qi and activating blood circulation, enhancing Qi and nourishing Yin, warming Yang for diuresis, eliminating phlegm and dampness, rescuing from collapse by restoring Yang, and corresponding classic prescriptions in prevention and treatment of CHF were concluded under the guidance of TCM syndrome differentiation thinking. Meanwhile, research progress on the modern pharmacological effects of these classic prescriptions was systematically discussed, so as to establish a unique treatment system for CHF by classic prescriptions under the guidance of TCM syndrome differentiation theory and provide innovative diagnosis and treatment strategies for clinical CHF.

Investigating the impact of chronic heart failure on in-hospital outcomes following transcatheter mitral valve repair or replacement: a national inpatient sample study (2016-2020)

Abstract Background Chronic heart failure (CHF) is a global health problem and one of the primary causes of morbidity and mortality worldwide. Transcatheter mitral valve repair or replacement (TMVr or TMVR) is a procedure that has demonstrated improved outcomes in patients with severe mitral valve disease. However, the impact of CHF on in-hospital outcomes following TMVR or TMVr remains unclear. Methods In this retrospective cohort study, we utilized the United States National Inpatient Sample database from 2016 to 2020. We identified patients who underwent TMVR or TMVr using ICD-10 codes and stratified them based on the presence or absence of CHF diagnosis. We assessed in-hospital complications, length of stay, and cost of care as primary and secondary outcomes. We performed multivariate logistic regression analysis to control for potential confounders. Results Our study included 48,885 patients who underwent TMVR or TMVr, of which 16,132 (33%) had a diagnosis of CHF. The cohort was predominantly male (54%) with a mean age of 76 years. Compared to patients without CHF who underwent TMVR/TMVr, those with CHF had lower rates of in-hospital mortality, valvular complications, cardiogenic shock, vascular complications, bleeding, blood transfusions, respiratory failure, acute kidney injury, and acute myocardial infarction (see Figure 1). Additionally, patients with CHF had a reduced length of stay (coefficient -3.48; p <0.001) and cost of care (coefficient -$58749.37; p <0.001). However, there were no significant differences in rates of pericardial tamponade, intracranial hemorrhage, or ischemic strokes. Conclusions Our findings suggest that patients with chronic heart failure (CHF) who underwent transcatheter mitral valve repair or replacement (TMVr or TMVR) had better in-hospital outcomes compared to those without CHF. This may be due to a protective effect of the chronic disease, where compensatory mechanisms developed by the body may help patients with CHF better tolerate the procedure and have decreased in-hospital complications. These results highlight the importance of further investigating the role of CHF in TMVr/TMVR outcomes and tailoring patient selection for these procedures.

Artificial intelligence empowered digital platform to support patients with heart failure (AZIMUTH platform)

Abstract Background Despite continuous efforts, Heart Failure (HF) is the leading cause of hospital readmission in developed countries. Since this tendency worsens prognosis of patients and increases health care costs, it raises concerns about the sustainability of the overburdened traditional model of care. Contributing factors to readmission include inadequate treatment of risk factors and low adherence to medications. Purpose The AZIMUTH study aimed at evaluating the feasibility, patient acceptance and perceived value of a certified medical device class IIa, smartphone app-based model of care, designed to improve quality of care and clinical outcomes for HF patients. Methods The AZIMUTH-I multicentric trial enrolled 185 patients with a diagnosis of chronic HF. At enrollment, patients are supplied with the mobile application and IoT devices. Data were accessible through a clinical dashboard meant for the healthcare professionals to remotely monitor the individual patients. During the observational period of 12 months, the patients were asked to daily report their feelings and symptoms, to share vital parameters, to record medications and to answer questionnaires regarding quality of life (KCCQ) and medication adherence (MMAS-8). They were also allowed to digitally send medical reports and to address questions to a mutidisciplinary clinical staff. The user acceptance was recorded using the User Experience Questionnaire (UEQ-S) and the Friends and Family Test (FFT). Results Our ehealth-empowered approach was tested in a cohort of 185 chronic heart failure patients (mean age 74 ± 12 years, mean LVEF 47 ± 13 %, mean NYHA class 2 ± 0.5). After a median follow-up of 11 months, all patients completed the study. The engagement was very high: 75% of opened the app at least once a day, showing a remarkable willingness to share additional data, consisting in 8231 "patient-reported outcome measures" (PROM). The average adherence to mandatory tasks was 74.8% whereas the adherence to medication reporting was 84.2%. The median result of the UEQ was "excellent" and the FFT revealed an overall experience between "positive" and "very positive". A significant decrease in the rate of re-hospitalization was observed at 12 months when compared with the same period before the implementation of the AZIMUTH model of care (1±0.2 vs 3±0.3 p<0.01) and was accompanied with a significant increase in the perceived quality of life (KCCQ overall score 71.2±20.7vs78.5±23.5; clinical score 77.4±20.1vs82.6±21.5 p<0.05). Conclusion This trial proved that our ehealth-integrated HF care is feasibile, user-friendly, scalable with high adherence and perceived benefits. The preliminary clinical findings and the high number of interactions suggest that the adoption of similar digital platform may not only improve the quality of life but also generate savings in health expenditures. Further study is eagerly awaited to evaluate the clinical efficacy of this new model of care.

Abstract 15602: Impact of COVID-19 on Cardiovascular Outcomes in Patients Hospitalized With Chronic Heart Failure: A Nationwide Propensity-Matched Analysis

Introduction: Coronavirus 19 (COVID-19) has rapidly emerged as a major contributor to hospitalizations and readmissions, with growing evidence emphasizing its correlation with adverse outcomes in heart failure (HF). This study aims to investigate the impact of COVID-19 on cardiovascular outcomes in patients hospitalized with HF. Goals: To assess the impact COVID-19 on mortality, readmissions, and other cardiovascular outcomes in HF patients. Methods: Patients >18 years hospitalized with a diagnosis of chronic HF and COVID-19 were identified in the 2020 National Readmissions Database. Nearest propensity matching (PSM) was conducted using a 1:1 ratio for demographic, social, and clinical variables. PSM was repeated for systolic and diastolic heart failure subgroups. Outcomes with <10 cases were excluded per HCUP rules. Results: Amongst the 1,922,680 CHF patients identified, 461 had COVID-19. Baseline characteristics are shown in Table 1. After matching, COVID-19 showed no significant impact on mortality, 30- and 90- day readmissions, acute myocardial infarction, or acute kidney injury (AKI). Interestingly, the subgroup analysis revealed that COVID-19 significantly reduced AKI in diastolic HF (Table 2). Conclusions: Patients with COVID-19 hospitalized with HF are not at a higher risk for mortality, readmissions, or other cardiovascular outcomes. Interestingly, a significant reduction in AKI was observed in diastolic HF patients with COVID-19, warranting further investigation.

Relationship between free circulating DNA levels, ejection fraction and brain natriuretic peptide levels in patients with chronic heart failure: prospective observational study

BACKGROUND: Chronic heart failure (CHF) is one of the most serious problems in cardiovascular diseases, requiring accurate diagnosis and treatment. The search for new laboratory markers of CHF can improve the accuracy of diagnosis and identify the severity of the patients condition.
 AIM: Our aim was to study the relationship between the levels of free-circulating DNA (cfDNA) and brain natriuretic peptide (NT-proBNP) in the blood plasma of patients suffering from CHF with ejection fraction (EF), to investigate the relationship between these laboratory markers, and to evaluate the dynamics of changes in the studied parameters against the background of drug therapy.
 MATERIALS AND METHODS: The study involved 67 patients of both sexes with a diagnosis of CHF, verified by clinical and functional methods. 23 people without established chronic diseases formed the control group. At the stage of inclusion in the study, all patients underwent: physical examination, general blood test, biochemical blood test with determination of lipid profile, glucose, creatinine, NT-proBNP and cfDNA levels, as well as electrocardiography (ECG), electrocardiography (ECHO-CG), radiography of organs chest, ultrasound of the abdominal organs, 6-minute walk test. The level of cfDNA was determined using the method of P.P. Laktionov, S.N. Tamkovich, E.Yu. Rykova (2005). Repeated blood sampling with assessment of cfDNA and NT-proBNP levels was carried out in the group of patients with reduced ejection fraction 57 months from the start of treatment/correction of previous therapy.
 RESULTS: The study revealed significant differences in the levels of cfDNA in the blood plasma in patients with different EF (less than 40%, 4049%, 50% or more). At the same time, an inverse relationship was established between cfDNA indicators and EF, as well as between the level of NT-proBNP and EF, that is, a progressive decrease in myocardial contractility is accompanied by a combined increase in the levels of the studied markers in the blood, reflecting the severity of the patients condition. In addition, the positive effect of drug therapy on cfDNA and NT-proBNP levels in the group of patients with EF 40% has been proven.
 CONCLUSION: The identified patterns make it possible to consider the level of cfDNA in blood plasma as a potential biomarker of CHF, and also to use it for dynamic monitoring of patients.

Expression of m6A Regulator Genes can Facilitate the Diagnosis of Chronic Heart Failure.

RNA N6-methyladenosine (m6A) is the most common type of modification in eukaryotic mRNA. The relationship between m6A modification and disease has been studied extensively, but there have been few studies on chronic heart failure (CHF). This study investigated a possible role for m6A in the diagnosis of CHF. Seven candidate m6A regulators (writers: WTAP and ZC3H13; readers: YTHDF3, FMR1, IGFBP1, and ELAVL1; eraser: FTO) were identified using a random forest (RF) model and the GSE5406 dataset from the Gene Expression Omnibus database. A nomogram model was developed to predict the risk of CHF, while consensus clustering methodology assigned CHF samples into two m6A patterns (cluster A and cluster B) according to the 7 candidate m6A regulators. Principal component analysis was used to calculate an m6A score for each sample and to quantify m6A patterns. Decision curve analysis and the nomogram model were used to obtain predictions that may be of clinical use. Patients in cluster B had higher m6A scores than patients in cluster A. Cluster B patients also had higher expression levels (ELs) of IL-4, IL-5, IL-10 and IL-13 than patients in cluster A, whereas cluster A patients had a higher EL for IL-33. The m6A cluster B pattern likely represents the ischemic heart failure (HF) disease group. m6A regulators are important in the pathogenesis of CHF associated with ischemic and idiopathic dilated cardiomyopathy, and may prove useful for the diagnosis and treatment of CHF.

Analysis of the Diagnostic Value of Echocardiography in Patients with Chronic Heart Failure

Objective: This study aims to analyze the diagnostic value of echocardiography in patients with chronic heartfailure. Methods: 30 patients with chronic heart failure admitted to our hospital during January 2021 to January 2023 were selected as the observation group, and 30 healthy people who received physical examination in our hospital during the same period were selected as the reference group. Both groups received echocardiography, and the results of the ultrasound examination were compared, and the subjects in the observation group were grouped according to the New York Heart Association (NYHA) cardiac function grading standard. The results of echocardiography in patients with chronic heart failure of different cardiac function grades were compared. Results: The left ventricular ejection fraction (LVEF) and ratio of maximum blood flow in the early diastole (E) to movement speed (A) (E/A) in the observation group were lower than those in the reference group, while the left ventricular posterior wall thickness (LVPWd), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left atrial diameter (LAD), and interventricular septal thickness (IVS) were higher than those of the reference group (P < 0.05). With the continuous increase of cardiac function grades, the levels of LVEF and E/A in patients with chronic heart failure continued to decrease, while the levels of LVPWd, LVEDD, LVESD, LAD, and IVS continued to increase, and there were significant differences among the groups (P < 0.05).Conclusion: The application of echocardiography in the clinical diagnosis of chronic heart failure can accurately evaluate the changes of cardiac shape and cardiac function, and provide a reliable basis for clinical diagnosis with a high application value.

Serum Levels of Hcy, sST2 and CA-125 in CHF Patients and Their Correlation with Cardiac Function Classification.

The relationships between serum levels of homocysteine (Hcy), soluble stromelysin 2 (sST2), and tumor-associated cancer antigen 125 (CA-125) and heart failure requires further investigation. The aim of the present study was to evaluate the levels of Hcy, sST2 and CA-125 in patients with congestive heart failure and to correlate these with cardiac function, thereby providing a reference for the clinical diagnosis and treatment of heart failure. Seventy patients with chronic heart failure (CHF) diagnosed between August 2020 and July 2022 were classified into heart failure groups II (n = 25), III (n = 23) and IV (n = 22). Seventy individuals with normal physical examination results were selected as the healthy group. Serum Hcy, sST2 and CA-125 levels for all participants were evaluated and correlated with each other and with cardiac function classification. The diagnostic value of individual Hcy, sST2, CA-125 levels for CHF was evaluated, as well as a combination of these factors. Hcy, sST2, and CA-125 levels were lower in the healthy group than in the heart failure group. Moreover, a progressive increase in Hcy, sST2, and CA-125 levels were observed in heart failure groups II, III, and IV. Individual Hcy, sST2 and CA-125 levels, as well as a combination of these factors, were significantly correlated with cardiac function classification (p < 0.05). Hcy, sST2 and CA-125 levels each showed diagnostic value for CHF, with the three combined having the best diagnostic value. Abnormally high levels of Hcy, sST2 and CA-125 occur in CHF patients and are positively correlated with cardiac function classification. Individual levels of these factors, and particularly a combination of the three, show good sensitivity and specificity for CHF diagnosis that could be widely used in clinical practice.

Chronic heart failure in patients undergoing major head and neck surgery: A hospital-based study

ObjectiveTo investigate the effects of chronic heart failure on various post-operative outcomes in head and neck cancer patients undergoing major cancer surgery. Study designFor this retrospective cohort study of patients undergoing major head and neck cancer surgery, a sample of 10,002 patients between 2017 and 2019 were identified through the Nationwide Inpatient Sample. SettingPatients were selected as undergoing major head and neck cancer surgery, defined as laryngectomy, pharyngectomy, glossectomy, neck dissection, mandibulectomy, and maxillectomy, then separated based on pre-surgical diagnosis of chronic heart failure. MethodsThe effects of pre-operative chronic heart failure on post-surgical outcomes in these patients were investigated by univariable and multivariable logistic regression using ICD-10 codes and SPSS. ResultsA diagnosis of chronic heart failure was observed in 265 patients (2.6 %). Patients with chronic heart failure had more preexisting comorbidities when compared to patients without chronic heart failure (mean ± SD; 4 ± 1 vs. 2 ± 1). Multivariable logistic regression showed that chronic heart failure patients had significantly greater odds of dying during hospitalization (OR 2.86, 95 % CI 1.38–5.91) and experiencing non-routine discharge from admission (OR 1.89, 95 % CI 1.41–2.54) after undergoing major head and neck cancer surgery. ConclusionChronic heart failure is associated with greater length of stay and hospital charges among head and neck cancer patients undergoing major head and neck cancer surgeries. Chronic heart failure patients have significantly greater rates of unfavorable post-operative outcomes, including death during hospitalization and non-routine discharge from admission.

СРАВНЕНИЕ ИНФОРМАТИВНОСТИ ОПРЕДЕЛЕНИЯ NT-PROBNP ПОЛУКОЛИЧЕСТВЕННЫМ И КОЛИЧЕСТВЕННЫМ МЕТОДАМИ ДЛЯ РАННЕЙ ДИАГНОСТИКИ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ

Вackground. Heart failure (HF) is one of the main causes of morbidity and mortality worldwide. Since it is important to diagnose CH early and quickly, at the outpatient appointment, there is a need to create and introduce into practice a portable highly sensitive method for the determination of BNP, NT-proBNP. Purpose of the study. To determine the possibility of using reagents for semi-quantitative determination of N-terminal brain natriuretic peptide antigen for early detection of heart failure. Methods of statistical analysis. Microsoft Office Excel 2019 program was used. Patient Characterization and Research Methods. An open cross-sectional non-randomized cohort study included 50 patients (mean age 63.5 years) who applied on an outpatient basis for consultation to a cardiologist. In addition to standard clinical, biochemical and instrumental examinations, the concentration of N-terminal brain natriuretic peptide (NT-proBNP) was determined by quantitative and semi-quantitative immunochromatographic method (LLC NPO "BioTest", Novosibirsk). The diagnosis of chronic heart failure (CHF) was established in accordance with national and European recommendations. Methods of statistical analysis. Microsoft Office Excel 2019 program was used. Results and conclusion. In the course of the study, it was found that semi-quantitative method is highly sensitive for detection of small NT-proBNP elevations, which is important for early diagnosis of heart failure, including subclinical forms. Semi-quantitative method also allows to distinguish a group of patients with high NT-proBNP values. The relationship of NT-proBNP level with the course and prognosis of CHF requires further study.

The association between erector spinae muscle content and chronic heart failure and its severity.

Previous studies have shown a significant reduction in skeletal muscle content in patients with chronic heart failure (CHF). The present study focused on the erector spinae muscle (ESM) to determine whether ESM content is associated with the development and severity of CHF. A total of 652 patients were included in this trial for the study. According to the diagnostic criteria of CHF, 652 patients were divided into two groups, namely, the control group (268 patients) and the CHF group (384 patients). Meanwhile, to assess whether the ESM is associated with the severity of CHF, patients in the CHF group were divided into two groups according to left ventricular ejection fraction (LVEF) values: heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%, 256 patients) and heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%, 68 patients). Receiver operating curve analysis was performed to assess whether ESM content could predict CHF and determine its severity. Compared with the control group, the patients in the CHF group were older, the prevalence of coronary heart disease (CHD) and atrial fibrillation was higher, the colour ultrasound results showed that LVEF decreased significantly, and the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly. Besides, patients in the CHF group had significantly lower ESM content, and ESM is an independent predictor of heart failure, with an odds ratio of 0.713 (CHF group vs. control group, 95% confidence interval 0.626-0.811, P<0.001). Compared with the HFpEF group, the HFrEF group has a lower prevalence of CHD, LVEF decreased significantly, the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly, also patients in the HFrEF group had significantly lower ESM content compared with patients in the HFpEF group, and ESM is an independent predictor of the severity of heart failure, with an odds ratio of 0.514 (HFrEF group vs. HFpEF group, 95% confidence interval (0.418-0.633, P<0.05). The results of receiver operating curve analysis showed that the sensitivity and specificity of ESM content for the diagnosis of CHF were 65.6% and 71.6%, respectively, while the sensitivity and specificity of ESM content for predicting the severity of CHF were 47.1% and 89.1%, respectively. The ESM is of great value in predicting the onset and severity of CHF.

Клинические особенности течения хронической сердечной недостаточности при новой коронавирусной инфекции

According to statistics, the number of patients with chronic heart failure (CHF) is growing in Russia. The cause of CHF can be various comorbid conditions that will aggravate the course of CHF. Objective. To determine the clinical features of the course of CHF in the context of COVID-19. Materials and methods. The retrospective study included 210 patients with a confirmed diagnosis of CHF and COVID-19 hospitalized in the pulmonology department. To assess the course of CHF, we used data on the severity of CHF symptoms (severity of shortness of breath on the mMRC scale, chest pain, presence of edema, level of physical activity) and objective examination data (blood pressure level, pulse dynamics). Results and conclusions. The risk group for severe COVID-19 included patients over 60 years of age with concomitant diseases. The clinical picture is noteworthy: severe shortness of breath, significant limitation of physical activity, and swelling in some patients. Patients with CHF during the treatment of COVID-19 require mandatory correction of both the underlying and concomitant diseases to prevent decompensation of CHF and death from all causes.

Modern genetic markers of chronic heart failure

Due to the rapid spread and large coverage, chronic heart failure (CHF) is reaching the state of a pandemic of the 21st century. Among elderly patients, HF is the main reason for referral to hospital. Half of patients with this pathology die within 5 years after diagnosis. Currently, the diagnosis of CHF is gaining momentum due to the importance of this disease. There are more and more studies and works that prove the high sensitivity of cardiac markers for diagnosing CHF. There are many genes that can participate in the formation of a hereditary predisposition, both independently and through interaction with each other. This literature review was carried out in order to identify genetic markers for diagnosing CHF. The results of studies that can be used to analyze the effect of polymorphism of the genes coding angiotensinogen, angiotensin-converting enzyme, β2-adrenoreceptor, nitric oxide synthase, aldosterone synthase are presented. An in-depth study of molecular genetic markers, as well as determining their significance in the development of heart failure, is an urgent problem of modern medicine, the solution of which will make it possible to carry out effective prevention of cardiovascular complications, optimize treatment and improve the prognosis of patients. Information on the topic from publications based on the PubMed, eLibrary databases was used.

Low LncRNA LUCAT1 Expression Assists in the Diagnosis of Chronic Heart Failure and Predicts Poor Prognosis.

Chronic heart failure (CHF) is a complicated syndrome caused by structural and functional abnormalities. Long noncoding RNA (LncRNA) lung cancer-associated transcript 1 (LUCAT1) downregulation inhibits cardiomyocyte apoptosis. This study aimed to measure LUCAT1 expression in patients with CHF and to explore its clinical value on CHF diagnosis and prognosis. A total of 94 patients with CHF and 90 participants without CHF were registered, followed by recording of their clinical characteristics and grading of their cardiac function. LUCAT1 expression in sera of patients with CHF and participants without CHF was detected. The correlation of LUCAT1 with brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) in patients with CHF and the diagnostic efficiency of LUCAT1, BNP, and LUCAT1 combined with BNP on patients with CHF were analyzed. Patients with CHF were treated with conventional drugs and followed up. The LUCAT1 expression in patients with CHF was lower than that in participants without CHF and was downregulated with the increase of New York Heart Association stage. LUCAT1 expression was negatively associated with BNP but positively associated with LVEF in the sera of patients with CHF. The receiver operating characteristic curve of LUCAT1 combined with BNP had better result than that of LUCAT1 and BNP alone. Low LUCAT1 expression indicated poor prognosis of patients with CHF and was an independent prognostic factor for the survival of patients with CHF. To summarize, low lncRNA LUCAT1 expression might help diagnose and predict the poor prognosis of CHF.

Diastolic heart failure: boundaries of term application

Important changes regarding the understanding of the pathogenesis of chronic heart failure (CHF) marked the beginning of the millennium, and its first decade was called the decade of diastology. Even though numerous studies convincingly proved that deterioration of the left ventricular (LV) filling pressure often precedes impairment of its systolic function and a number of factors affect (especially at the onset) mainly the diastolic function without changing the conditions of blood ejection, modern classifications and approaches to CHF treatment are primarily based on the results of LV ejection fraction (EF) assessment.In recent years, diastolic heart failure (DHF) has been often overlooked and replaced by the ambiguous term “CHF with preserved EF”. However, sometimes authors use the term DHF extensively, since CHF based on myocardial insufficiency develops only via two mechanisms (systolic and / or diastolic dysfunction), and excluding one of the mechanisms allows to identify the underlying one. The term DHF can be used in clinical practice and cannot be replaced by the diagnosis of CHF with preserved EF. CHF with preserved EF is a broader concept which includes a full spectrum of cardiovascular diseases, complicated by the development of CHF without depression of the global LV contractility and requiring differentiated approaches to therapy. In addition, the results of repeated studies on LVEF in many patients may require reclassification of this CHF phenotype, which is established following the analysis of the baseline value of global LV contractility. We join M.R. Zile in the appeal to stop discriminating against the term “DHF” and present the boundaries of its correct application.

Raman spectroscopy in chronic heart failure diagnosis based on human skin analysis.

This work aims at studying Raman spectroscopy in combination with chemometrics as an alternative fast noninvasive method to detect chronic heart failure (CHF) cases. Optical analysis is focused on the changes in the spectral features associated with the biochemical composition changes of skin tissues. A portable spectroscopy setup with the 785 nm excitation wavelength was used to record skin Raman features. In this in vivo study, 127 patients and 57 healthy volunteers were involved in measuring skin spectral features by Raman spectroscopy. The spectral data were analyzed with a projection on the latent structures and discriminant analysis. 202 skin spectra of patients with CHF and 90 skin spectra of healthy volunteers were classified with 0.888 ROC AUC for the 10-fold cross validated algorithm. To identify CHF cases, the performance of the proposed classifier was verified by means of a new test set that is equal to 0.917 ROC AUC.

Distribution of traditional Chinese medicine syndromes and syndrome elements of chronic heart failure based on network analysis and hierarchical cluster analysis

Objective: To explore the distributions of syndromes and syndrome elements of chronic heart failure (CHF), so as to provide a point of reference to the research on diagnosis and treatment of CHF, the study on syndrome standardization, and objective research of TCM diagnosis. Methods: The clinical research articles on CHF syndromes in recent 40 years were retrieved from Wanfang Data, CNKI, CqVIP, SinoMed, PubMed, Scopus, Web of Science, and Embase. The cumulative frequencies of CHF syndromes, syndrome elements, and their corresponding cases were counted and compared. The syndrome elements were analyzed by network analysis, and the symptoms were analyzed by hierarchical cluster analysis. Results: A total of 278 Chinese articles with 71 syndromes and 31 syndrome elements were included after two rounds of screening. The research on CHF syndrome has kept a regular activeness till now, but its development was geographically uneven. The distribution of CHF syndromes gained from the cumulative frequencies of syndromes appeared in the articles were in line with that gained from the cumulative frequencies of the cases corresponding to syndromes. The network analysis found four communities of syndrome elements, indicating the deficiency-excess in complexity of CHF pathology, which can be inferred as some common CHF syndromes. The hierarchical cluster analysis on CHF symptoms showed that the distribution of CHF syndromes included five types. Conclusion: The distribution of CHF syndromes includes syndrome of qi deficiency with blood stasis, syndrome of qi and yin deficiency, syndrome of yang deficiency with water retention, syndrome of heart blood stasis obstruction, syndrome of turbid phlegm, and syndrome of collapse due to primordial yang deficiency. The syndrome elements on location of illness are heart, kidney, lung, and spleen, and the syndrome elements on nature of illness are qi deficiency, blood stasis, yang deficiency, yin deficiency, water retention, and turbid phlegm.

A study on the rapid diagnosis of chronic heart failure by measuring the difference in pulse oxygen saturation before and after arm compression.

Clinically, the pulse oxygen saturation of patients with chronic heart failure does not decrease significantly, and the clinical manifestations of labor-related dyspnea are not typical. As such, it is difficult to make a rapid diagnosis. To investigate changes in pulse oxygen saturation in patients with chronic heart failure and examine the relationship between B-type natriuretic peptide (BNP) and normal pulse oxygen saturation. A total of 80 hospitalized patients with chronic heart failure and increased BNP were randomly selected as the study group; the family members of 60 patients without dyspnea were randomly selected as the control group. The researchers measured the value of pulse oxygen saturation before and after upper arm compression, calculating the difference and analyzing the correlation between this difference and BNP values. The data were statistically analyzed using the SPSS Statistics 17.0 program. The decrease in pulse oxygen saturation in the study group was greater than in the control group; the decrease in pulse oxygen saturation of patients with chronic heart failure positively correlated with BNP. The value of pulse oxygen saturation in patients with chronic heart failure decreased more than in the control group, and this difference positively correlated with BNP. The measurement of pulse oxygen saturation before and after upper arm compression is a simple and effective method for diagnosing and evaluating chronic heart failure.