Methods of correction of chronic heart failure in patients of older age groups against the background of depressive disorders

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Abstract

Chronic heart failure (CHF) is a common disease in patients of older age groups. Often these patients experience depressive disorders that affect the course of chronic diseases and their standard of living.

Purpose. To study methods for increasing the effectiveness of treatment of CHF against the background of depressive disorders in patients of older age groups.

Material and methods. The study involved 100 patients aged 60–87 years with functional class II–III CHF and mild to moderate depressive disorders. Patients were divided into groups depending on the therapy received: 1st (n=25) – standard therapy for CHF; 2nd (n=25) – standard therapy for CHF + antidepressant; 3rd (n=25) – standard therapy for CHF + phototherapy; 4th (n=25) – standard therapy for CHF + placebo. The effectiveness of CHF therapy was assessed after 3 and 6 weeks during clinical examination using a 6-minute walk test, ECG, echocardiography, and a clinical condition rating scale. To diagnose depressive disorders, the Geriatric Depression Scale, HADS, Beck scale, and consultations with a psychotherapist were used.

Results. After 6 weeks of therapy, patients of all groups noted a decrease in shortness of breath and chest pain, and an increase in tolerance to physical activity. At the same time, the decrease in the level of anxiety and depression was most pronounced in groups 2 and 3 – in 84 and 100% of cases, respectively.

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About the authors

Yu Е. Antonenkov

N.N. Burdenko Voronezh State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: oltaniks@list.ru

Professor, MD

Russian Federation, Voronezh

О. N. Taranina

N.N. Burdenko Voronezh State Medical University, Ministry of Health of Russia

Email: oltaniks@list.ru
Russian Federation, Voronezh

А. V. Chernov

N.N. Burdenko Voronezh State Medical University, Ministry of Health of Russia

Email: oltaniks@list.ru

Associate Professor, MD

Russian Federation, Voronezh

References

  1. Ткачева О.Н., Консон К., Дудинская Е.Н. Активное долголетие. Практическое руководство. Под общ. Ред. О.Н. Ткачевой. М.: ГЭОТАР-Медиа, 2021; 232 с. [Tkacheva O.N., Konson K., Dudinskaya E.N. Active longevity. Practical guide. Ed. by O.N. Tkacheva. M.: GEOTAR-Media, 2021; 232 p (in Russ.)].
  2. Орлова Я.А., Ткачева О.Н., Арутюнов Г.П. и др. Особенности диагностики и лечения хронической сердечной недостаточности у пациентов пожилого и старческого возраста. Мнение экспертов Общества специалистов по сердечной недостаточности, Российской ассоциации геронтологов и гериатров и Евразийской ассоциации терапевтов. Кардиология. 2018; 58 (S12): 42–72 [Orlova I.A., Tkacheva O.N., Arutyunov G.P. et al. Features of diagnostics and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Experts in Heart Failure, Russian Association of Gerontologists, and Euroasian Association of Therapists. Kardiologiia. 2018; 58 (12S): 42–72 (in Russ.)]. doi: 10.18087/cardio.2560
  3. Борисов В.А., Таранина О.Н., Силютина М.В. Хроническая сердечная недостаточность на фоне депрессивных расстройств у лиц старших возрастных групп: способы коррекции. Системный анализ и управление в биомедицинских системах. 2017; 16 (2): 260–4 [Borisov V.A., Taranina O.N., Silyutina M.V. Correction of chronic heart failure and depressive disorders in older age groups. System analysis and management in biomedical systems. 2017; 16 (2): 260–4 (in Russ.)].
  4. Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т. и др. Истинная распространенность ХСН в Европейской части Российской Федерации (исследование ЭПОХА, госпитальный этап). Сердечная недостаточность. 2011; 12 (2): 63–8 [Belenkov Yu.N., Mareev V.Yu., Ageev F.T. et al. The true prevalence of CHF in the European part of the Russian Federation (EPOCH study, hospital stage). Heart Failure. 2011; 12 (2): 63–8 (in Russ.)].
  5. Поляков Д.С., Фомин И.В., Беленков Ю.Н. и др. Хроническая сердечная недостаточность в Российской Федерации: что изменилось за 20 лет наблюдения? Результаты исследования ЭПОХА-ХСН. Кардиология. 2021; 61 (4): 4–14 [Polyakov D.S., Fomin I.V., Belenkov Yu.N. et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021; 61 (4): 4–14 (in Russ.)]. doi: 10.18087/cardio.2021.4.n1628
  6. Агеев Ф.Т., Даниелян М.О., Мареев В.Ю. и др. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения (по материалам исследования ЭПОХА–О–ХСН). Сердечная Недостаточность. 2004; 5 (1): 4–7 [Ageev F.T., Danielyan M.O., Mareev V.Yu. et al. Patients with chronic heart failure in Russian outpatient practice: features of the contingent, diagnosis and treatment (based on the materials of the EPOCH–O–CHF study). Heart Failure. 2004; 5 (1): 4–7 (in Russ.)].
  7. Агеев Ф.Т., Беленков Ю.Н., Фомин И.В. и др. Распространенность хронической сердечной недостаточности в Европейской части Российской Федерации – данные ЭПОХА–ХСН. Сердечная Недостаточность. 2006; 7 (1): 112–5 [Ageev F.T., Belenkov Yu.N., Fomin I.V. et al. The prevalence of chronic heart failure in the European part of the Russian Federation – EPOCH–CHF data. Heart Failure. 2006; 7 (1): 112–5 (in Russ.)].
  8. Хроническая сердечная недостаточность. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 25 (11): 4083 [Chronic heart failure. Clinical guidelines 2020. Russian Journal of Cardiology. 2020; 25 (11): 4083 (in Russ.)]. doi: 10.15829/1560-4071-2020-4083
  9. Федеральные клинические рекомендации по диагностике и лечению хронической и острой сердечной недостаточности (Часть 2). Неотложная кардиология. 2015; 1: 54–62 [Federal Clinical guidelines for the diagnosis and treatment of chronic and acute heart failure (Part 2). Emergency Cardiology. 2015; 1: 54–62 (in Russ.)].
  10. Таранина О.Н., Силютина М.В., Борисов В.А. Коррекция хронической сердечной недостаточности и депрессивных расстройств у пациентов старших возрастных групп. Хирургическая практика. 2017; 1: 45–50 [Taranina O.N., Silutina M.V., Borisov V.A. Correction of chronic heart failure and depressive disorders in older age groups. Surgical practice (Russia). 2017; 1: 45–50 (in Russ.)].
  11. Нургалиева А.К., Койгельдинова Ш.К., Тургунова Л.Г. Влияние депрессии и тревожности на качество жизни лиц с высоким кардиоваскулярным риском. Медицина и экология. 2018; 4: 8–17 [Nurgaliyeva A.K., Koigeldinova Sh.K., Turgunova L.G. The effect of depression and anxiety on the quality of life in high cardiovascular risk people. Medicine and ecology. 2018; 4: 8–17 (in Russ.)].
  12. Freedland K.E., Carney R.M., Rich M.W. Effect of depression on prognosis in heart failure. Heart Fail Clin. 2011; 7 (1): 11–21. doi: 10.1016/j.hfc.2010.08.003
  13. Fan H., Yu W., Zhang Q. et al. Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis. Prev Med. 2014; 63: 36–42 (in Russ.)]. doi: 10.1016/j.ypmed.2014.03.007
  14. Мареев В.Ю., Агеев Ф.Т., Арутюнов Г.П. и др. Национальные рекомендации ОССН, РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр) Утверждены на Конгрессе ОССН 7 декабря 2012 года, на Правлении ОССН 31 марта 2013 и Конгрессе РКО 25 сентября 2013 года. Сердечная Недостаточность. 2013; 14 (7): 379–472 [Mareev V.Y., Ageev F.T., Arutyunov G.P. et al. National recommendations of the OSS, RKO and RNMOT on the diagnosis and treatment of CHF (fourth revision) Approved at the OSSN Congress on December 7, 2012, at the OSSN Board on March 31, 2013 and the RKO Congress on September 25, 2013. Heart Failure. 2013; 14 (7): 379–472 (in Russ.)].
  15. Ткачева О.Н., Котовская Ю.В., Рунихина Н.К. и др. Клинические рекомендации «Старческая астения». Российский журнал гериатрической медицины. 2020; 1: 11–46 [Tkacheva O.N., Kotovskaya Yu.V., Runikhina N.K. et al. Clinical guidelines on frailty. Russian Journal of Geriatric Medicine. 2020; 1: 11–46 (in Russ.)]. doi: 10.37586/2686-8636-1-2020-11-46
  16. Ткачева О.Н., Котовская Ю.В., Рунихина Н.К. и др. Клинические рекомендации «Старческая астения». Часть 2. Российский журнал гериатрической медицины. 2020; 2: 115–30 [Tkacheva O.N., Kotovskaya Yu.V., Runikhina N.K. et al. Clinical guidelines frailty. Part 2. Russian Journal of Geriatric Medicine. 2020; 2: 115–30 (in Russ.)]. doi: 10.37586/2686-8636-2-2020-115-130
  17. Смулевич А.Б. Депрессии в общей медицине: Руководство для врачей. Психиатрия (электронное издание) [Smulevich A.B. Depressions in general medicine: A guide for doctors. Psychiatry (electronic edition) (in Russ.)]. URL: http://www.psychiatry.ru/lib/1/book/22/chapter/37

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Patients distribution in the study groups depending on the functional class of CHF before treatment

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3. Fig. 2. Patients distribution in the study groups depending on the degree of depression severity before treatment

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4. Fig. 3. Patients distribution in the study groups depending on the functional class of CHF after 3 weeks of therapy

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5. Fig. 4. Patients distribution in the study groups depending on the degree of depression severity after 3 weeks of therapy

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6. Fig. 5. Patients distribution in the study groups depending on the functional class of CHF after 6 weeks of therapy

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7. Fig. 6. Patients distribution in the study groups depending on the degree of depression severity after 6 weeks of therapy

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