Clinical course and outcomes of chronic heart failure with preserved left ventricular ejection fraction in concomitant overweight and obesity with comorbid atrial fibrillation

Abstract

Aim. To study the features of the clinical course and outcomes of chronic heart failure with preserved left ventricular ejection fraction (CHFprEF) in overweight and obese patients with concomitant atrial fibrillation (AF). Materials and methods. 248 overweight and obese patients with CHFprEF, aged 65.0 ± 11.0 years, 146 females (58.9 %) and 102 males (41.1 %) were examined. The first group consisted of 181 patients without concomitant AF, mean age 64.0 ± 11.0 years, 110 females (60.8 %) and 71 males (39.2 %). The second group included 67 patients with AF, mean age 67.9 ± 11.3 years, 36 females (53.7 %) and 31 males (46.3 %). Results. Comorbid AF was associated with a more severe course of CHFprEF by the rating scale of clinical state (0.9 points), Borg scale (1.7 points), a significant predominance of orthopnea (by 16.6 %), night cough (by 27.9 %), cardiac asthma (by 27.2 %), low exercise tolerance (by 14.3 %), weakness (by 23.7 %), palpitations (by 72.9 %), edema of the feet (by 40.6 %), rapid weight gain (by 32.6 %), jugular venous distention (by 21.4 %), pathological third heart sound (by 16.7 %), percussion extension of the cardiac borders (by 41.4 %) and dullness over the lungs (28.9 %), moist rales (24.3 %), second sound with a loud pulmonic component (by 33.9 %), tachypnea (by 25.9 %), hepatomegaly (by 32.0 %) and ascites (by 13.6 %), increased risk of cumulative endpoint (by 2.7 times), five-year mortality (by 3.4 times) and rehospitalization (by 3 times) (P ˂ 0.001). Conclusions. AF as the comorbidity in overweight and obese patients is associated with more severe clinical course of CHFprEF and worse five-year outcomes.

Keywords

• clinical course
• outcomes
• chronic heart failure
• preserved ejection fraction
• obesity
• atrial fibrillation