medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2087-5631-2024-54-47-52medalphabet-4014Research ArticleСтатьиАссоциация состава тела пациентов с хронической сердечной недостаточностью с течением заболеванияAssociation of body composition of patients with chronic heart failure with the course of the diseasehttps://orcid.org/0000-0002-1707-436XШевцоваВ. И.ShevtsovaV. I.

Шевцова Вероника Ивановна, к.м.н., доцент кафедры поликлинической терапии

Воронеж

Shevtsova Veronika I., PhD Med, associate professor at Dept of Polyclinic Therapy

Voronezh

shevvi@yandex.ruhttps://orcid.org/0009-0002-9026-7763ПашковаА. А.PashkovaA. A.

Пашкова Анна Александровна, д.м.н., проф., зав. кафедрой поликлинической терапии

Воронеж

Pashkova Anna A., DM Sci (habil.), professor, head of Dept of Polyclinic Therapy

Voronezh

apashkova@vrngmu.ruhttps://orcid.org/0009-0009-3171-2880СаламатоваВ. Н.SalamatovaV. N.

Саламатова Валерия Николаевна, студентка 6-го курса лечебного факультета

Воронеж

Salamatova Valeriya N., student of the 6th year at Faculty of General Medicine

Voronezh

valeriyasalamatova@gmail.comhttps://orcid.org/0000-0001-8641-2847ШевцовА. Н.ShevtsovA. N.

Шевцов Артем Николаевич, к.м.н, доцент кафедры оперативной хирургии с топографической анатомией

Воронеж

Shevtsov Artem N., PhD Med, associate professor at Dept of Operative Surgery with Topographic Anatomy

Voronezh

shan87@yandex.ruhttps://orcid.org/0000-0003-4796-7334КрасноруцкаяО. Н.KrasnoruckayaO. N.

Красноруцкая Ольга Николаевна, д.м.н., доцент, проф. кафедры поликлинической терапии

Воронеж

Krasnoruckaya Olga N., DM Sci (habil.), professor at Dept of Polyclinic Therapy

Voronezh

89805520393onk@gmail.comФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава РоссииРоссияVoronezh State Medical University named after N.N. BurdenkoRussian Federation202406122024024Современная поликлиника (2)4752Copyright © Шевцова В.И., Пашкова А.А., Саламатова В.Н., Шевцов А.Н., Красноруцкая О.Н., 20242024Шевцова В.И., Пашкова А.А., Саламатова В.Н., Шевцов А.Н., Красноруцкая О.Н.Shevtsova V.I., Pashkova A.A., Salamatova V.N., Shevtsov A.N., Krasnoruckaya O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4014Цель

Цель. Выявление зависимости между нутритивным статусом пациентов, страдающих хронической сердечной недостаточностью (ХСН), и их клиническим состоянием.

Материалы и методы

Материалы и методы. В исследовании приняли участие 298 человек: 115 мужчин и 183 женщины (средний возраст – 61 год). После проведения оценки состава тела пациенты были поделены на 5 групп: 1-я группа – сниженная масса + саркопения (n=45); 2-я группа – нормальная масса + саркопения (n=79); 3-я группа – нормальная масса без саркопении (n=49); 4-я группа – ожирение + саркопения (n=72); 5-я группа – ожирение без саркопении (n=53). Выполнена оценка клинического состояния пациентов в исследуемых группах с определением функционального класса (ФК), фракции выброса (ФВ), а также проведен анализ таких лабораторных показателей, как С-реактивный белок (СРБ), N-концевой натрийуретический пропептид В-типа (NT-proBNP) и галектин‑3.

Результаты

Результаты. Наиболее неблагоприятное течение ХСН определялось у пациентов со сниженной массой тела и саркопенией. Так, в 1-й группе чаще, чем в других, встречался IV ФК (42,2%), II ФК не определялся вовсе. Значения ФВ были наиболее низкими и составляли 27–36%. Наименее тяжелое течение ХСН наблюдалось у пациентов с нормальной массой тела без саркопении. В 3-й группе чаще встречался II ФК (67,3%). При этом ФВ была сниженной или промежуточной. В группах с ожирением течение заболевания было менее благоприятным, чем в группе с нормальным составом тела. Однако лучше, чем у больных только с саркопенией. В 4-й (47,2%) и 5-й (52,8%) группах чаще встречался III ФК, а значения ФВ превышали 50%.

Заключение

Заключение. Изменения состава тела пациентов, страдающих ХСН, определенно связаны с выраженностью заболевания и относятся к неблагоприятным прогностическим факторам. Для выбора наиболее эффективной тактики лечения больных необходимо идентифицировать клинические фенотипы ХСН с оценкой компонентов состава тела.

Aim

Aim. To identify the relationship between the nutritional status of patients suffering from chronic heart failure (CHF) and their clinical condition.

Materials and methods

Materials and methods. The study involved 298 people: 115 men and 183 women (the average age was 61 years). After body composition assessment, the patients were divided into 5 groups: group 1 – reduced weight + sarcopenia (n=45); group 2 – normal weight + sarcopenia (n=79); group 3 – normal weight without sarcopenia (n=49); 4th group – obesity + sarcopenia (n=72); group 5 – obesity without sarcopenia (n=53). The clinical condition of patients in the study groups was assessed with the determination of functional class (FC), ejection fraction (EF), and the analysis of laboratory parameters such as C-reactive protein (CRP), N-terminal natriuretic propeptide B-type (NT-proBNP) and galectin‑3 was carried out.

Results

Results. The most unfavorable course of CHF was determined in patients with reduced body weight and sarcopenia. Thus, in group 1, FC IV was more common than in others (42.2%), FC II was not determined at all. The EF values were the lowest and amounted to 27–36%. The least severe course of CHF was observed in patients with normal body weight without sarcopenia. FC II was more common in group 3 (67.3%). At the same time, the EF was reduced or intermediate. In the obese groups, the course of the disease was less favorable than in the group with normal body composition. However, it is better than in patients with sarcopenia alone. In groups 4 (47.2%) and 5 (52.8%), FC III was more common, and the values of the EF exceeded 50%.

Conclusion

Conclusion. Changes in the body composition of patients suffering from CHF are definitely associated with the severity of the disease and relate to unfavorable prognostic factors. To choose the most effective treatment tactics for patients, it is necessary to identify the clinical phenotypes of CHF with an assessment of the components of body composition.

хроническая сердечная недостаточностьсостав теласаркопениясаркопеническое ожирение.chronic heart failurebody compositionsarcopeniasarcopenic obesity.ReferencesCarbone S, Billingsley HE, Rodriguez-Miguelez P. et al. Lean mass abnormalities in heart failure: the role of sarcopenia, sarcopenic obesity, and cachexia. Curr Probl Cardiol. 2019; 100417. DOI: 10.1016/j.cpcardiol.2019.03.006Carbone S, Billingsley HE, Rodriguez-Miguelez P. et al. Lean mass abnormalities in heart failure: the role of sarcopenia, sarcopenic obesity, and cachexia. Curr Probl Cardiol. 2019; 100417. DOI: 10.1016/j.cpcardiol.2019.03.006Soto ME, Pérez-Torres I, Rubio-Ruiz ME, Manzano-Pech L, Guarner-Lans V. Interconnection between Cardiac Cachexia and Heart Failure-Protective Role of Cardiac Obesity. Cells. 2022; 11 (6). DOI: 10.3390/cells11061039Soto ME, Pérez-Torres I, Rubio-Ruiz ME, Manzano-Pech L, Guarner-Lans V. Interconnection between Cardiac Cachexia and Heart Failure-Protective Role of Cardiac Obesity. 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The authors declare that there are no conflicts of interest present.