Features of chronic heart failure depending on the left ventricular ejection fraction

Abstract

Aim. To assess clinical and demographic data, structural and functional features of the myocardium in patients with chronic heart failure (CHF) with a preserved ejection fraction in comparison with patients with CHF with an intermediate (CHF-inEF) and a reduced ejection fraction (CHF-rEF).Material and methods. The study included 186 patients with CHF I-IIB stages, I-III functional classes. One hundred and three patients had a preserved ejection fraction (EF) (≥50%), 43 — intermediate (40-49%) and 40 — reduced (<40%). All patients underwent a comprehensive clinical examination, as well as standard echocardiography.Results. Among patients with CHF-rEF, remodeling of the left ventricular myocardium by the type of concentric hypertrophy was more often observed (69,9%), and among CHF-inEF and CHF-nEF patients — by the type of eccentric hypertrophy (88,4 and 875%, respectively). Restrictive diastolic dysfunction was observed in 2,0% of patients with CHF-rEF and in 21,7% of patients with EF less than 50%.Conclusion. The severity of the clinical course of CHF does not depend on the left ventricular EF. Epidemiology and etiology of CHF-rEF has fundamental differences from CHF-inEF and CHF-nEF: CHF-rEF is more common among women over 60 years old with arterial hypertension and obesity. For patients with CHF-inFV, myocardial remodeling by the type of concentric hypertrophy and the prevalence of non-restrictive types of diastolic dysfunction are characteristic.