Clinical characteristics and quality assessment of the treatment of patients with chronic heart failure with diabetes mellitus

Aim. A study of the clinical and instrumental characteristics and quality of treatment of patients with chronic heart failure (CHF) with diabetes mellitus. Materials and methods. The study was conducted by using the CHF register method, which is a computer program with remote access, which allows on-line data collection on patients who have been examined and treated in primary care and in hospitals. The study included 8272 patients with CHF IIIV FC (functional class) (New York Heart Association NYHA); among them 62% of patients were treated in hospital. Results. The study showed that the frequency of diabetes was 21%. The main causes of CHF in diabetic patients are coronary artery disease, myocardial infarction (in anamnesis) and hypertension. These patients are more often diagnosed with III and IV CHF FC according to (NYHA) and retained LV (left ventricular) ejection fraction. The reduced ejection fraction was observed in 6.8% of cases, and the frequency of the intermediate LV was significantly higher than among patients with CHF and with diabetes and accounted for 18.9%. At patients with CHF with diabetes in comparison with patients with CHF without diabetes, atherosclerosis of the peripheral arteries, stroke (in anamnesis) and chronic kidney disease of stage III and IV were significantly more common. Conclusion.Under the treatment, patients with CHF with diabetes have higher levels of SBP (systolic blood pressure), lipids and glucose in the blood plasma, indicating a lack of quality of treatment and, accordingly, the doctors are not optimally performing the clinical guidelines on treating this category of patients.

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Interim Results of the BYHEART Observational Study: Exogenous Phosphocreatine Effect on the Quality of life of Patients with Chronic Heart Failure

Kardiologiia ◽

10.18087/cardio.2021.7.n1649 ◽

2021 ◽

Vol 61 (7) ◽

pp. 22-27

Author(s):

S. N. Tereschenko ◽

N. B. Perepech ◽

I. A. Cheremisina ◽

V. N. Belov ◽

Y. A. Vollis ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

Aim Improvement of quality of life is one of the most important goals for the treatment of patients with chronic heart failure (CHF). This study searched for ways to increase the efficiency of CHF treatment based on parameters of quality of life in CHF patients during and after the treatment with exogenous phosphocreatine (EP).Material and methods The effect of a single course of EP treatment on quality of life of patients with functional class (FC) II-IV CHF with reduced or mid-range left ventricular ejection fraction was studied as a part of the all-Russia prospective observational study BYHEART. The presence of FC II-IV CHF and a left ventricular ejection fraction <50 % were confirmed by results of 6-min walk test (6MWT) and findings of echocardiography after stabilization of the background therapy.Results An interim data analysis showed that the course of EP treatment was associated with a significant improvement of quality-of-life indexes as determined by the Minnesota Living with Heart Failure Questionnaire (LHFQ) total score. These indexes significantly increased and remained at a satisfactory level for 6 mos. following completion of the treatment course. Also, the treatment significantly beneficially influenced the clinical condition of patients (heart failure severity scale), results of 6MWT, and the increase in left ventricular ejection fraction.Conclusion The conclusions based on results of the interim analysis should be confirmed by results of the completed study. Complete results are planned to be published in 2022.

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Pentoxyphylline: possibilities to reduce manifestations of chronic heart failure with preserved left ventricular ejection fraction in elderly

Zaporozhye Medical Journal ◽

10.14739/2310-1210.2021.1.224839 ◽

2021 ◽

Vol 23 (1) ◽

pp. 24-31

Author(s):

V. B. Shatylo ◽

L. A. Bodretska ◽

I. S. Shapovalenko ◽

H. P. Voinarovska ◽

Zh. S. Butynets

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

The aim: to study the effect of add-on pentoxifylline therapy on the structural and functional indicators of the heart state, endothelial function, quality of life and physical abilities in patients with chronic heart failure with preserved left ventricular ejection fraction. Materials and methods. The indicators of the structural and functional state of the heart, endothelial function, quality of life and physical abilities of patients older than 60 years, who were followed-up in the Department of Cardiology of the State Institution “D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine”, based on 67 case histories, 37 of them were prescribed pentoxifylline as add-on therapy to the standard therapeutic regimen. Statistical data were calculated using modern application packages, in particular SPSS v.22, Statistica 7.0, MedCalc statical software v.11.5.0.0. The significance level was assessed using paired and unpaired Student's t-test with Bonferroni corrections, and the correlation and two-way analysis of variance were performed. Results. A significant additional effect of pentoxifylline treatment on the indicators of maximum blood flow in the forearm microvessels in response to the reactive hyperemia test, which characterizes the ability of the microvessel endothelium to synthesize relaxation factors, was detected. Patients who additionally received pentoxifylline showed significantly better indicators of left ventricular myocardial relaxation and reduction of hypertrophy than those on the standard therapy. There was a significant increase in walking distance in the third year of treatment in the patients who additionally received pentoxifylline. There was no difference in the impact on the quality of life of the patients. Conclusions. The addition of pentoxifylline to the standard therapy in patients with chronic heart failure with preserved left ventricular ejection fraction significantly reduces myocardial hypertrophy, improves diastolic relaxation, increases volumetric blood flow velocity in microvessels mediating reactive hyperemia, which may contribute to further stabilizing the clinical course of the disease and increasing 6-minute walking distance. The presented data are an additional evidence of pathogenetically reasonable therapy with pentoxifylline in patients with chronic heart failure with preserved left ventricular ejection fraction, which allows us to consider this drug as potentially promising for the routine treatment of such patients.

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