Russian Heart Failure Journal 2007year Age-related peculiarities of morpho-functional cardiac parameters, heart rhythm variability, kidney condition, and quality of life in patients with chronic heart failure


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2007/

Age-related peculiarities of morpho-functional cardiac parameters, heart rhythm variability, kidney condition,
and quality of life in patients with chronic heart failure

Statsenko M.E., Sporova O.E., Belenkova S.V., Ivanova D.A.

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Urgency. Timely diagnosis of renal dysfunction and optimal therapy which effectively improves the condition of patients can slow down the progression of CHF, improve quality of life (QL), and prolong life time of these patients. Aim: Comprehensive evaluation of cardio-renal interrelations and QL in patients with CHF at the early postinfarction period in relation to age. Materials and methods. 148 patients aged from 46 to 85 years were evaluated 15–30 days after IM complicated with CHF. Based on WHO Guidelines patients were divided to three age groups: Group 1, mature (n=62); mean age 52.7±0.91 years; Group 2, elderly (n=60); 67.8±0.93 years; Group 3, senile; (n=26); 78.5±0.78 years. Clinical evaluation, determination of CHF FC, echoCG, examination of renal function and heart rhythm variability (HRV) were performed in all patients using Seattle and Minnesota questionnaires. Study results. Percentage of patients with disorders of heart structure and function, renal dysfunction, increased activity of the sympathetic division of autonomic nervous system, and reduced QL increased with age. A strong relationship between renal function, cardiac function, autonomic homeostasis and QL exists in patients with CHF in early postinfarction period. Nitrogen excretion and filtration renal function progressively impair with increasing CHF FC; proportion of patients with exhausted functional renal reserve (FRR) and microalbuminuria (MAU) increases. Patients with reduced GFR and detectable MAU display more pronounced decreases in Minnesota questionnaire QL as compared to patients without MAU and with preserved renal filtration function. Detection of MAU in patients was associated with increased activity of higher autonomic centers and tension of adaptive mechanisms as compared to patients without MAU.

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