The Frequency of Comorbidity in Patients with Chronic Heart Failure and Preserved Ejection Function Depending On Age

Тhe aim of our study was to determine characteristics of heart failure (HF) with preserved ejection fraction (EF) by analyzing the frequency of comorbid diseases in patients with HF and preserved ejection fraction depending on age.

Methods: retrospective analysis of 198 patients with heart failure and preserved ejection fraction ( m - 106 pts, f - 92 pts). Patients were divided into 3 groups according to age: 1st - 40-59 years old (n=74), 2nd - 60-75 (n=73), 3rd - >75 years old(n=51). The average EF (M ± m) - (63,8 ± 6,3)%. The presence of arterial hypertension, anemia, chronic obstructive pulmonary disease (COPD), diabetes, thyroid function, body mass index, renal function, intracardiac hemodynamics were analyzed.

Results: Comorbidity was observed in all examined patients. 169 pts had arterial hypertension. Revealed age changes in the comorbidity: prevalence increases with age changes in renal function ( 29,7% in the 1^st group, 26% in 2^nd and 29,4% in the 3^rd), hypothyroidism ( 25,7% in the 1^st group, 38,4% in the 2^ndgroup and 23,5% in the 3^rd), COPD ( 2,7% in the 1^st group, 10,2% in the 2^ndgroup and 7,8% in the 3^rd), anemia ( 16,3% in the 1^st group), hyperuricemia ( 16,2% in the 1^st group and 21,6% in the 3^rd). Thus in all age groups more than half of patients had obesity, hypertension, stable angina and a quarter of patients - diabetes. End-systolic size and end-systolic volume were the highest in the second group, than may indicate bad prognosis (41,8% and 21,3% accordingly). Increased size of the left atrium, the average pressure in the pulmonary artery and aortic root changes were higher in patients over 75 years (4,4±1,1 sm, 34,2±4,3mmHg and 13% accordingly). Appointment of medical therapy met the requirements in all cases. Determined increase in prescription of loop diuretics in the 3^rdgroup (70,5%) and low frequency of use of beta-blockers in the 1^stgroup (63,5%). Metabolic therapy which does not meet the requirements of evidence is still being used very often (from 50% in the 1^st group and 25,5% in the 3^rd ).

Conclusions: A high level of comorbidity in patients with chronic heart failure and preserved ejection fraction that increases with age was revealed.