Zaporožskij Medicinskij Žurnal (Jun 2017)
Gender features of heart failure with preserved ejection fraction in patients with myocardial infarction on the background of hypertension
Abstract
Actuality of chronic heart failure problem remains due to its increasing prevalence in all developed countries, includingUkraine. The aim – to evaluate the gender features in patients with heart failure with preserved ejection fraction after myocardial infarction on the background of hypertension. Materials and Methods. The study involved 72 patients (50 men and 24 women) with heart failure and preserved ejection fraction after myocardial infarction on the background of hypertension (the average age was 64.1 ± 0.97 years). Patients were divided into two groups according to gender. Evaluation of intracardiac hemodynamics was carried out by echocardiography on the device “VIVID 3 Expert” (“General Electric”,USA) using the standard method with tissue Doppler. Levels of GDF 15 and NTproBNP in blood serum were identified by use the ELISA kits of Human GDF 15/MIC-1 ELISA (“BioVendor”,Czech Republic) and NTproBNP ELISA Kit (“Biomedica”,SlovakRepublic). Results. Clinical condition of women with heart failure and preserved ejection fraction after myocardial infarction on the background of hypertension was more severe, which was confirmed by significantly higher scores on the scale of clinical status assessment (40 %, p < 0.05) and reduction the distance covered (33.4 %; p < 0.05), and more points on the Borg’s scale (22.6 %; p < 0.05) according to 6-minute walking test. In female patients significant increasing in E/E' ratio (by 12.2 %, p < 0.05) and GDF 15 serum levels (by 30.3 %, p < 0.05) was found compared to male patients. In women with heart failure and preserved ejection fraction after myocardial infarction on the background of hypertension, the total mortality rate within 3 years was significantly higher (16 %) than men (10 %). Conclusions. Female patients with heart failure and preserved ejection fraction after myocardial infarction on the background of hypertension had a severe course of the disease, as evidenced by a lower exercise tolerance, diastolic function impairment and the worsening of three-year survival prognosis.
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