engleski

Preserved ejection fraction and inflammatory markers in acute heart failure patients with concomitant metabolic syndrome

Purpose: Metabolic syndrome (MS) is important concomitant disease in acute heart failure (AHF) thus its effection HF pathways is crucial field of investigation. The aim of this study was to investigate influence of MS on AHF with emphasised relationship with ejection fraction (EF). Methods: Research was performed as observational, prospective study on hospitalised AHF patients (pts.) recruited from the Emergency Department (ED), from November 2013 to February 2015. Participants were divided in two groups depending on presence of MS and preserved EF. Pts. were compared according to preserved EF, erythrocyte sedimentation rate (ESR) and level of C- reactive protein (CRP). Pts. were treated by standard protocol for AHF treatment by ESC Guidelines. Study was approved by local Ethics committee. Written informed consent was obtained from each pt. according to Good Clinical Practice and Helsinki Declaration principles. Pts. clinical presentation, diagnostic procedures and laboratory tests were recorded in electronic register. Results: Complete analysis included data for 152 pts., 79 (51.9%) women. Totally 105 (69.1%) pts. had worsening of chronic HF type (male/female ratio 63/74.7%) and 47 (30.9%) had de novo HF. In total 85 (55.9%) pts. had MS, among whom 56 (65.9%) had worsening of CHF, and 29 (34.1%) had de novo type. Mean age pts. with MS was 74.06 (±SD10.28), and without MS was 76.55 (±SD 10.12). ccording to HF classification (ACCF/AHA Heart Failure Guideline 2013) there were total of 83 (57.6%) pts. with reduced (HFrEF) and 61 (42.4%) with preserved (HFpEF). MS and HFrEF had 46 (56.8%) pts. Preserved EF was noted for 46 (62.2%) of pts. with MS and only 28 (37.8%) of pts. without MS. In laboratory parameters ESR mean value was 21 (±SD 23, Min 1; Median 14, Max 105). Respectively, for pts. with MS mean value was 24 (±SD 25) and for pts. with no MS it was 19 (±SD21). CRP value in total was 20.24 (±SD 30.47), respectively for pts. with MS mean value was 20.87 (±SD 32.90), and for pts. without MS mean value was 19.42 (±SD 27.2). Conclusions: MS is important concomitant parameter in developing HF. Surprisingly presented data showed more preserved EF in MS patients. According to the results of this study MS could be offered as focus comorbidity for influencing outcome of HF pts. Considering pts. with MS were younger, age could be cause of their better EF results. It could be concluded that according to preserved EF, despite increased levels of inflammatory markers MS is significant comorbidity.

heart failure ; inflammatory markers ; metabolic syndrome

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