Лечащий Врач (Dec 2024)
The level of c-reactive protein in patients with chronic heart failure, depending on body composition
Abstract
Background. Changes in body composition are associated with the course of diseases, including chronic heart failure. In chronic heart failure, changes in body composition such as sarcopenia, obesity, sarcopenic obesity and cachexia are common. The association between obesity and chronic heart failure is especially characteristic for patients with preserved ejection fraction. At the same time, the researchers note the mutual influence of the disease and body composition due to pathogenetic changes in the neurohumoral system, which is supported by metaflammation in CHF. C-reactive protein is a marker of systemic inflammation, and the combination of weight loss and systemic inflammation are criteria for cachexia.Objective. To study the association of changes in the level of hs-CRP with the clinical status and body composition of patients with chronic heart failure.Material and methods. The body composition and clinical characteristics of the disease course in 298 patients with chronic heart failure due to cardiovascular diseases and hypertension were evaluated. The patients were divided into 5 groups depending on body weight and the presence of sarcopenia. The functional activity of patients, systolic function of the left ventricle, and the level of hs-CRP were determined.Results. HFpEF was more common in obese patients. The worst results of functional activity were typical for patients with reduced body weight and sarcopenia, while the rates of patients with sarcopenic obesity were worse than those of patients with obesity alone or sarcopenia alone. The level of the hs-CRP marker in the group of patients with sarcopenic obesity (Ме 6.53 mg/l [3.95-8.01]) significantly differed from the indicator in the groups of patients without sarcopenia (Ме 3.89 mg/l [3.85-5.46]), without obesity (Ме 3.9 mg/l [3.15-5.37]) and without disorders body composition (Ме 4.4 mg/l [2.78-5.23]). The values were comparable in the groups of patients with sarcopenic obesity and with reduced body weight and sarcopenia.Conclusions. The course of chronic heart failure varies depending on body composition. The HFpEF phenotype is more often associated with obesity. The level of hs-CRP reflects the level of systemic inflammation, which is the pathogenetic basis of both chronic heart failure and sarcopenic obesity. The activity of metaflammation in sarcopenic obesity affects the functional activity of a patient with chronic heart failure.
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