Multiple hormonal and metabolic deficiency syndrome in chronic heart failure: rationale, design, and demographic characteristics of the T.O.S.CA. Registry

Abstract Aims Recent evidence supports the occurrence of multiple hormonal and metabolic deficiency syndrome (MHDS) in chronic heart failure (CHF). However, no large observational study has unequivocally demonstrated its impact on CHF progression and outcome. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Treatment in Heart Failure) Registry has been specifically designed to test the hypothesis that MHDS affects morbidity and mortality in CHF patients. Methods and Results The T.O.S.CA. Registry is a prospective, multicentre, observational study involving 19 Italian centres. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydropianoandrosterone sulfate, insulin resistance, and the presence of diabetes were evaluated. A MHDS was defined as the presence of ≥2 hormone deficiencies (HDs). Primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Four hundred and eighty heart failure patients with ejection fraction ≤45% were enrolled. MHDS or diabetes was diagnosed in 372 patients (77.5%). A total of 271 events (97 deaths and 174 cardiovascular hospitalizations) were recorded, 41% in NO-MHDS and 62% in MHDS (P < 0.001). Median follow-up was of 36 months. MHDS was independently associated with the occurrence of the primary endpoint [hazard ratio 95% (confidence interval), 1.93 (1.37–2.73), P < 0.001] and identified a group of patients with a higher mortality [2.2 (1.28–3.83), P = 0.01], with a graded relation between HDs and cumulative events (P < 0.01). Conclusion MHDS is common in CHF and independently associated with increased all-cause mortality and cardiovascular hospitalization, representing a promising therapeutic target. Trial registration ClinicalTrials.gov identifier: NCT023358017

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Clinical and demographic characteristics of an outpatient Russian population with chronic heart failure at the time of enrollment in the QUALIFY registry for evaluating consistency with clinical guidelines on drug therapy

Kardiologiia ◽

10.18087/cardio.2363 ◽

2017 ◽

Vol 17 (S2) ◽

pp. 324-330

Author(s):

S. N. Tereshchenko ◽

◽

I. V. Zhirov ◽

A. A. Petrukhina ◽

◽

...

Keyword(s):

Heart Failure ◽

Drug Therapy ◽

Chronic Heart Failure ◽

Clinical Guidelines ◽

Demographic Characteristics ◽

Russian Population

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Commentary to the article “Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry”, Antonio Cittadini et al. Eur J Prev Cardiol. 2021

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666211215144023 ◽

2021 ◽

Vol 21 ◽

Author(s):

Vincenzo Triggiani ◽

Giuseppe Lisco

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Insulin Resistance ◽

Chronic Heart Failure ◽

Endocrine System ◽

Serum Testosterone ◽

Dehydroepiandrosterone Sulfate ◽

Deficiency Syndrome ◽

Adaptive Mechanisms

: Chronic heart failure represents a relevant concern for public health. The endocrine system is heavily involved in the induction and progression of chronic heart failure. Among endocrine dysfunction, the most relevant alterations are related to the growth hormone-insulin like growth factor 1 axis, serum testosterone, dehydroepiandrosterone sulfate, triiodothyronine levels, insulin resistance, and type 2 diabetes mellitus. It is currently debated whether these changes might be simple adaptive mechanisms or, instead, they may deteriorate myocardial pump function over time. Medical management of patients exhibiting one or more hormonal deficiencies or metabolic disorders, including insulin resistance and diabetes mellitus, may have a therapeutic role.

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Clinico-demographic characteristics of the patients with decompensated chronic heart failure Clinico-demographic characteristics of the patients with decompensated chronic heart failure

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2011-2-75-80 ◽

2011 ◽

Vol 10 (2) ◽

pp. 75-80

Author(s):

S. N. Tereshchenko ◽

I. V. Kositsyna ◽

N. A. Dzhaiani ◽

N. A. Gnidkina ◽

A. V. Golubev

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Diuretic Therapy ◽

Therapy Resistance ◽

Demographic Characteristics ◽

Hemoglobin Level ◽

Hospital Treatment ◽

Moscow City ◽

The Mean

Aim. To study clinico-demographical characteristics of the patients with decompensated chronic heart failure (CHF). Material and methods. The analysis included the data of 112 patients hospitalised at Moscow City Clinical Hospital No. 68 due to decompensated CHF. The follow-up period lasted 30 days. Results. The mean age of the patients (33 % men, 67 % women) was 70,3±9,9 years. Older age (>70 years) was significantly more prevalent in women than in men (р=0,005). The main reason for CHF decompensation was inadequate pre-hospital therapy. The mean duration of the in-hospital treatment was 17,5±6,4 days. The level of 30-day fatality was 12,5 % (n=14). According to correlation analysis results, systolic blood pressure (SBP) level <100 mm Hg positively correlated with 30-day fatality (r=0,4; р=0,0001). Hemoglobin level <100 g/l also positively correlated with 30-day fatality (r=0,3; р=0,05). Conclusion. The prevalence of decompensated CHF is higher in women. Compared to men, women develop CHF in more advanced age. The main fatality-associated factors were low hemoglobin level, SBP <100 mm Hg, and age >70 years. The leading causes of death were pulmonary thromboembolism and diuretic therapy resistance.

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CHRONIC HEART FAILURE WITH PRESERVED AND INTERMEDIATE LEFT VENTRICULAR EJECTION FRACTION, WAYS OF ITS CORRECTION (REVIEW)

JOURNAL OF CARDIORESPIRATORY RESEARCH ◽

10.26739/2181-0974-2020-2-4 ◽

2020 ◽

Vol 2 (1) ◽

pp. 28-34

Author(s):

Farzona Kadirova ◽

◽

Matluba Rakhimova ◽

Eleonora Tashkenbaeva ◽

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Objective Assessment ◽

Left Ventricular ◽

Demographic Characteristics ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Poor Outcomes

Current HF therapy is mainly focused on an objective assessment of LVEF, which has been shown to be a predictor of poor outcomes even in the absence of symptomatic HF. Historically, patients with HF were divided into 2 groups depending on their LVEF: LVlEFand LViEF. This distinction was important in the treatment of HF because of the different demographic characteristics, etiology, and comorbidities between the two groups

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