[Time-related changes in prevalence of chronic heart failure and diabetes mellitus in Nizhny Novgorod Region between 2000 and 2017].

AIM: To determine time-related changes in prevalence, morbidity, and all-cause mortality of patients with CHF depending on the presence of DM in a representative sample of Nizhny Novgorod Region. MATERIALS AND METHODS: In 1998, a representative sample of Nizhny Novgorod Region was created, which included 1922 respondents. From 2000 through 2017, this sample was evaluated three times. Patients with CHF and DM were studied. RESULTS: For 17 years, prevalence of NYHA FC IV CHF increased from 6.88 to 9.1 % (р=0.04). Prevalence of NYHA FC III-IV CHF increased considerably from 1.2 % to 4.8 % (р.

[The notion of CHF course stability: Is it acceptable for Russian practice?]

AIM: To evaluate preparedness of physicians in real clinical practice to strive for stabilizing the course of CHF by control of clinical and hemodynamic indexes both in prevention of admission for decompensated CHF and following discharge from the hospital. MATERIALS AND METHODS: The study included 750 CHF patients with any NYHA FC who were admitted in emergency for decompensated CHF. All patients with CHF were followed up for a year after discharge from the hospital. Medical records of inpatients (MRIP) and outpatients (MROP) were analyzed including determination of clinical symptoms and administered doses of medicines. Changes in clinical parameters during a year were recorded. RESULTS: CHF decompensation was evident as pulmonary edema in 1.6% of cases and acute left ventricular failure in 18.5% of cases. All the rest of decompensated CHF cases included ascites or hyposarca (21.1%), or increased edema syndrome with unstable hemodynamics (58.5%). In MROPs, weight control was presented for 1.2% of patients. The composite index of effectively achieved control of hemodynamics and body weight was only 0.2%. Treatment effectiveness decreases due to absence of drug titration and switching therapies, which considerably impairs prognosis for patients. CONCLUSION: Outpatient physicians lack alertness for development of CHF decompensation, and control of hemodynamics and body weight of patients remains ineffective. Physicians are not prepared to achieve recommended doses of medicines, which provokes high risk of fatal outcome and/or rehospitalization.

Predictors of community-acquired pneumonia in patients with acute decompensated heart failure: the results of the analysis of the hospital sample EPOHA-D-CHF.

AIM: Identify the most significant predictors of community-acquired pneumonia and their im-pact on the risk of this disease in patients with ADHF. MATERIALS AND METHODS: The analysis of the hospital sample of patients (n=852) with ADHF. In 16.5% of hospitalizations, community-acquired pneumonia was found. RESULTS: The presence of symmetrical rales in the lungs, hepatomegaly, left ventricular failure signs, dilated cardiomyopathy, hypotension are increasing the risk of pneumonia in 3.7 (p<0.001), 1.6 (p=0.02), 1.86 (p=0.005), 1.72 (p=0.002), 2.7 (p=0.003) times. CONCLUSION: Based on results of a single and multivariate regression analysis, the risk of pneumonia is statistically significant increase in patients with acute left ventricular failure, dilated cardiomyopathy, hypotension, with signs of stagnation in the small and large circulatory circles. Different combinations of these predictors were found in 80% of patients with ADHF, among which in 20% of cases there was a combination of 3-5 factors.

[Anticoagulant therapy and prognosis in patients with CHF and AF in the setting of real-life clinical practice].

BACKGROUND: Prevalence of atrial fibrillation (AF) grows with the increase in CHF FC and reaches 45% in III-IV FC CHF. With an adequate anticoagulant (AC) therapy, the risk of thromboembolic complications does not significantly differ between patients with I-II FC and III-IV FC CHF. Of particular interest is studying administration of the anticoagulant treatment and correspondence between the SAMe-TT2R2 scale and actual TTR values in patients with CHF and AF in real-life clinical practice. AIM: Toanalyze the efficacy of anticoagulant therapy and prognosis in patients with CHF and AF in the setting of real-life clinical practice. MATERIALS AND METHODS: The study included 272 patients with CHF and AF who were discharged from the hospital where they had been treated for decompensated CHF and who were followed up as outpatients for a year. Efficacy of the AC therapy was evaluated; parameters of CHA2DS2-VASc, HAS-BLED, and SAMe-TT2R2 scales were calculated at baseline. TTR was computed to determine the maintenance time. RESULTS: Patients with CHF had permanent (56.3%), persistent (38.6%), or paroxysmal (5.1%) AF. The mean CHA2DS2-VASc score was 3.83±1.16 and the mean HAS-BLED score was 1.3±0.83. SAMe-TT2R2 scores were 0 for 1.6% of patients; 1 for 36.9%, and 2< for 61.5%. At baseline, one third of patients with CHF and AF received antiplatelet therapy (APT) and every forth patient received no therapy. At one year, 69.0% of patients took AC on a constant basis (р.

[Evaluation of the impact of community-acquired pneumonia on short-term and long-term prognosis in a patient with chronic decompensated heart failure]. / Otsenka vliyaniya vnebol'nichnoi pnevmonii na kratkosrochnyi i dolgosrochnyi prognoz u bol'nogo s dekompensatsiei khronicheskoi serdechnoi nedostatochnosti.

AIM: To evaluate the impact of community-acquired pneumonia (CAP) on short-term and long-term prognosis in patients hospitalized with signs of chronic decompensated heart failure (CDHF). SUBJECTS AND METHODS: A total of 852 cases were admitted to therapy/cardiology hospital with signs of CDHF during a year. RESULTS: Among the patients hospitalized with signs of CDHF, the prevalence of CAP was 16.5%. This indicator did not depend on the age of hospitalized patients. Among the multisystem disorders, hypertension, different forms of coronary heart disease, diabetes mellitus, and chronic obstructive pulmonary disease were more common in the patients with CAP. The presence of the latter in a patient with CDHF statistically significantly increased the length of hospital stay (13.1 versus 11.9 days; p = 0.009) and also the probability of rehospitalization during a year (odds ratio (OR) 1.9; p = 0.02). The presence of CAP in a patient with CDHF resulted in an increase in mortality rates (OR 13.5; p < 0.001); moreover, the highest risk of a fatal outcome was noted on day 1 of hospitalization (12.7%). During one-year follow-up, the risk of death in patients hospitalized with CDHF and concomitant pneumonia proved to be higher (OR 4.8; p < 0.001) than in those without pneumonia.