RESUMO
AIM: Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection. MATERIALS AND METHODS: The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home. CLINICALTRIALS: gov ID NCT04492384. RESULTS: Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively. CONCLUSION: Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.
Assuntos
COVID-19 , Doenças Cardiovasculares , Doença das Coronárias , Diabetes Mellitus , Insuficiência Cardíaca , Hipertensão , Doenças não Transmissíveis , Adulto , Feminino , Humanos , Masculino , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doença Crônica , COVID-19/diagnóstico , COVID-19/epidemiologia , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Prognóstico , Sistema de Registros , SARS-CoV-2RESUMO
Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular diastolic dysfunction and normal filling pressure at rest. Diagnosis of HFpEF is improved by using diastolic transthoracic stress-echocardiography with dosed exercise (or diastolic stress test), which allows detection of increased filling pressure during the exercise. The present expert consensus explains the requirement for using the diastolic stress test in diagnosing HFpEF from clinical and pathophysiological standpoints; defines indications for the test with a description of its methodological aspects; and addresses issues of using the test in special patient groups.
Assuntos
Pesquisa Biomédica , Cardiologia , Insuficiência Cardíaca , Consenso , Ecocardiografia , Ecocardiografia sob Estresse , Teste de Esforço , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Federação Russa , Volume Sistólico , Função Ventricular Esquerda , Carga de TrabalhoRESUMO
At an international online expert meeting held on September 16, 2021, the results of the empagliflozin research program EMPA-REG Outcome, EMPEROR-Reduced and EMPEROR-Preserved were reviewed. We analyzed cardiovascular and renal outcomes during the treatment with empagliflozin in patients with chronic heart failure, regardless of the presence of type 2 diabetes mellitus. The positive results of the EMPEROR-Preserved study are updated and their significance for clinical practice is discussed. Several proposals have been adopted that will accelerate the introduction of empagliflozin therapy into practice in patients with heart failure and overcome clinical inertia.
Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Inibidores do Transportador 2 de Sódio-Glicose , Humanos , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucosídeos/efeitos adversos , Insuficiência Cardíaca/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológicoRESUMO
AIM: To determine a possibility for improving the capability of patients with chronic heart failure (CHF) for self-care and self-control using a remote monitoring platform on a basis of mobile application. MATERIALS AND METHODS: The study included 142 patients with CHF of different etiology. During the stay in hospital, patients attended structured classes on different aspects of self-control and self-care in CHF. The group of active management consisted of 47 patients who subsequently used a version of mobile application. The control group consisted of 95 patients with CHF. The remote monitoring platform was based on a translated to Russian version of the European Heart Failure Self-Care Behavior Scale (EHFScBS_9), which included 9 items addressing different issues of selfcontrol. Responses were presented as a scale ranging from "completely agree" (1) to "completely disagree (5). The total score was calculated by adding scores for each item. The lower the score the better was the capability of CHF patients for self-care. The followup duration was 6 months. RESULTS: On admission, the mean EHFScBS_9 score decreased to 15±2.3 in the mobile application group whereas in the control group, the mean score was 23.95±3.02, which indicated a significantly better capability for self-care in the mobile application group (p.
