Do age and gender influence the phenotype of chronic heart failure?
E.V. KHAZOVA, O.V. BULASHOVA
Kazan State Medical University, Kazan
Contact details:
Khazova E.V. — PhD (medicine), Associate Professor of the Department Propaedeutics of Internal Diseases named after Prof. S.S. Zimnitskiy
Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-905-313-97-10, e-mail: hazova_elena@mail.ru
The increase in life expectancy of the Russian population is accompanied by a tendency of aging of patients with coronary heart disease (CHD) and chronic heart failure (CHF). Attention is paid to gender differences in the contributions of individual characteristics to the formation of the heart failure clinical phenotype.
The purpose to determine the features of the clinical picture of chronic heart failure in patients with coronary heart disease, taking into account gender and age.
Material and methods. 517 patients with CHF and coronary heart disease of both genders were examined. A comparison was made of clinical, laboratory, and instrumental parameters of patients with CHF of different age periods, males and females.
Results. Until the age of 60, CHF was predominantly observed in men, in the group older than 75 years in women (p < 0.001). With increasing age, the proportion of nicotine dependent patients decreased, as well as the value of the metabolic index and exercise tolerance. In older patients with CHF, the levels of hemoglobin and triglycerides (TG) in blood decreased. The inverse correlation was found between age and left ventricular ejection fraction (LVEF) and LV end-diastolic size.
Among men, tobacco smoking (p = 0.001) and chronic obstructive pulmonary disease (p = 0.001) were found more often. In women, CHF was combined with diabetes mellitus (p < 0.001) and chronic kidney disease (p = 0.001). Female patients differed in levels of general cholesterol, triglyceride and non-high fraction blood cholesterol (p = 0.001, p = 0.023, p = 0.009). Men had more creatinine (p = 0.001) and blood uric acid (p = 0.014).
Conclusions. The study identified heart failure with preserved LVEF in 61.5% of men and 74.6% of women; CHF with moderately reduced LVEF — in 15.9% and 18.3%, and CHF with reduced LVEF — in 20.2% and 9.5% (p = 0.003), respectively.
Key words: chronic heart failure, age, gender differences.
REFERENCES
- 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 EPOCHA-CHF study. Kardiologiya, 2021, vol. 61 (4), pp. 4–14 (in Russ.).
- Mareev V.Yu., Fomin I.V., Ageev F.T. et al. Clinical recommendations OSSN — RKO — RNMOT. Heart failure: chronic (CHF) and acute decompensated (ADHF). diagnostics, prevention and treatment. Kardiologiya, 2018, vol. 58 (6S), pp. 8–158 (in Russ.).
- Orlova Ya.A., Tkacheva O.N., Arutyunov G.P. et al. Peculiarities of diagnosis and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Specialists in Heart Failure, the Russian Association of Gerontologists and Geriatricians and the Eurasian Association of Therapists. Kardiologiya, 2018, vol. 58 (S12), pp. 42–72 (in Russ.).
- Lee S.J. Development and Validation of a Prognostic Index for 4-Year Mortality in Older Adults. JAMA, 2006, vol. 295 (7), p. 801.
- Rich M.W. Geriatric Heart Failure: A Call for Papers. Journal of Cardiac Failure, 2016, vol. 22 (4), pp. 247–248.
- Curtis L.H., Whellan D.J., Hammill B.G. et al. Incidence and Prevalence of Heart Failure in Elderly Persons, 1994–2003. Archives of Internal Medicine, 2008, vol. 168 (4), pp. 418–424.
- Jhund P.S., MacIntyre K., Simpson C.R. et al. Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. Circulation, 2009, vol. 119 (4), pp. 515–523.
- Lloyd-Jones D.M., Larson M.G., Leip E.P. et al. Framingham Heart S. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation, 2002, vol. 106, pp. 3068–3072.
- Bleumink G.S., Knetsch A.M., Sturkenboom M.C. et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J, 2004, vol. 25, pp. 1614–1619.
- Lam C.S.P., Arnott C., Beale A.L. et al. Sex differences in heart failure. Eur Heart J, 2019, vol. 40 (47), pp. 3859–3868.
- Heo S., Shin M.S., Hwang S.Y. et al. Sex differences in heart failure symptoms and factors associated with heart failure symptoms. J Cardiovasc Nurs, 2019, vol. 34 (4), pp. 306–312.
- Razzolini R., Lin C.D. Gender differences in heart failure. Ital. J. Gender-Specific. Med, 2015, vol. 1, rr. 15–20.
- Belenkov Yu.N., Fomin I.V., Mareev V.Yu. et al. The prevalence of chronic heart failure in the European part of the Russian Federation — EPOCHA-CHF data (part 2). Serdechnaya nedostatochnost’, 2006, vol. 7, no. 3, pp. 3–7 (in Russ.).
- Ageev F.T., Belenkov Yu.N., Fomin I.V. et al. Prevalence of chronic heart failure in the European part of the Russian Federation — EPOCHA-CHF data. Serdechnaya nedostatochnost’, 2006, vol. 7, no. 1, pp. 112–115 (in Russ.).
- Roytberg G.E., Dorosh Zh.V., Sharkhun O.O. et al. Possibilities of using a new metabolic index in assessing insulin resistance in clinical practice. Ratsional’naya farmakoterapiya v kardiologii, 2014, vol. 10, no. 3, pp. 264–274 (in Russ.).
- Smirnov A.V., Shilov E.M., Dobronravov V.A. et al. National recommendations. Chronic kidney disease: basic principles of screening, diagnosis, prevention and treatment approaches. Nefrologiya, 2012, vol. 16, no. 1, pp. 89–115 (in Russ.).
- Chuchalin A.G., Aysanov Z.R., Chikina S.Yu. et al. Federal Clinical Guidelines of the Russian Respiratory Society for the Use of the Spirometry Method. Pul’monologiya, 2014, no. 6, pp. 11–24 (in Russ.).
- Rodriguez F., Wang Y., Johnson C.E., Foody J.M. National patterns of heart failure hospitalizations and mortality by sex and age. J Card Fail, 2013, vol. 19 (8), pp. 542–549.
- Fomin I.V. Chronic heart failure in the Russian Federation: what we know today and what we should do. Rossiyskiy kardiologicheskiy zhurnal, 2016, vol. 21, no. 8 (136), pp. 7–13 (in Russ.).
- Sandberg K., Ji H. Sex differences in primary hypertension. Biol. Sex. Differ, 2012, vol. 3, no. 1, rr. 1–21.
- Keller K.M., Howlett S.E. Sex Differences in the Biology and Pathology of the Aging Heart. Can. J. Cardiol, 2016, vol. 32 (9), rr. 1065–1073.
- Benjamin E.J., Muntner P., Alonso A. et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation, 2019, vol. 139 (10), pp. e56–e66.
- Belenkov Yu.N., Mareev V.Yu., Ageev F.T. et al. The true prevalence of CHF in the European part of the Russian Federation (hospital stage). Serdechnaya nedostatochnost’, 2011, vol. 64, no. 2, pp. 63–68 (in Russ.).
- Cediel G., Codina P., Spitaleri G. et al. Gender-Related Differences in Heart Failure Biomarkers. Front Cardiovasc Med, 2021, vol. 7, pp. 617–705.
- Dunlay S.M., Roger V.L., Redfield M.M. Epidemiology of heart failure with preserved ejection fraction. Nature reviews Cardiology, 2017, vol. 14 (10), pp. 591–602.
- Dushina A.G., Lopina E.A., Libis R.A. Features of chronic heart failure depending on the ejection fraction of the left ventricle. Rossiyskiy kardiologicheskiy zhurnal, 2019, vol. (2), pp. 7–11 (in Russ.).
- Hopper I., Kotecha D., Chin K.L. et al. Comorbidities in Heart Failure: Are There Gender Differences? Curr Heart Fail Rep, 2016, vol. 13 (1), pp. 1–12.