BENDOPNEA AND GLOBAL LEFT VENTRICULAR FUNCTION INDEX AS POSSIBLE FACTORS FOR PREDICTION OF MORTALITY IN PATIENTS WITH CHRONIC HEART FAILURE


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Abstract

In recent years, bendopnea and the left ventricular global function index (LVGFI) have been considered as markers of decompensation of cardiovascular diseases, while studies on the correlation of these markers in chronic heart failure (CHF) patients have not been presented. The aim of the study was to evaluate the correlation and prognostic value of LVGFI and bendopnea in outpatients with CHF aged 60 years and older. Material and methods. The study included 55 outpatients with CHF II-IV FC: 25 persons with bendopnea (64% of male patients) aged 75 (66; 79) years (main group) and 30 people without bendopnea (23% of male patients) aged 76 (73,5; 79) years (comparison group). LVGFI (%) was calculated by the following formula: LV/ [0.5 X (LV EDV + lV ESV) + LV myocardial mass/ 1.05] х 100. The follow-up period was 36 (24; 36) months. Results. LVGFI in the main group consisted 18,5 (16,6; 21,3)%, in the comparison group - 21.4 (19,5; 22,7)% (p=0.011). LVGFI correlated with bendopnea (r=-0,35, p=0,010), CHF FC(r=-0,52, p <0,001), N-terminal proBNP (r=-0,52, p=0,015), a history of myocardial infarction in anamnesis (r=-0,28, p=0,040). In its turn, bendopnea correlated with FC CHF (r=0,82, p <0,001) and N-terminal proBNP (r=0,54, p=0,012). The development of bendopnea is most likely in patients with LVGFI «20,5% (AUC 0,70±0,07; 95% CI: 0,56-0,84; p=0.011; sensitivity 64,0%, specificity 63,3%; OR 3,07; 95% CI: 1,02-9,26; p <0,05). The value of LVGFI for predicting death was «19,2% (AUC 0,79±0,07; 95% CI: 0,65-0,93; p=0.002; sensitivity 75,0%, specificity 74,4%). Multiple regression analysis revealed an association of bendopnea and death in patients with LVGFI «19,2% (R2=0,446; sensitivity 88,4%, specificity 75%). For the cohort of patients with bendopnea and LVGFI «19.2%, the Rr was 2,2 (95% CI: 1,15-4,20; p<0.05). Conclusion. The combination of bendopnea and LVGFI «19,2% reflects the severity of clinical condition, significant remodeling of the left ventricular myocardium, and with a high probability can predict a lethal outcome in the group of CHF elderly patients.

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About the authors

Vera N. Larina

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: larinav@mail.ru
Dr. med. habil., professor, head of the Department of polyclinic therapy of the Faculty of general medicine 117997, Moscow, 1 Ostrovityanova Str

Viktor I. Lunev

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: sandvit@ya.ru
assistant at the Department of polyclinic therapy of the Faculty of general medicine 117997, Moscow, 1 Ostrovityanova Str

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