Clinical Status of Patients with Unstable Angina and Chronic Heart Failure with Normal Ejection Fraction

Abstract

Chronic heart failure is a syndrome that develops as a result of a violation of the ability of the heart to fill and / or empty, occurring in conditions of an imbalance of vasoconstrictor and vasodilating neurohormonal systems, accompanied by insufficient perfusion of organs and systems and manifested by complaints: shortness of breath, weakness, palpitations and increased fatigue and, with progression, fluid retention in the body (edematous syndrome) [1, 3, 5]. At the present stage, the attention of cardiologists and therapists is drawn to the conditional polarity of CHF variants with low and normal left ventricular ejection fraction (LVEF), since relatively recently it has become obvious that approximately half of all cases of CHF occur with a normal or borderline state of the contractile function of this chamber of the heart [2, 4, 6]. In the first years of this century, the prevalence of this variant of CHF was 3-5% in the general population of people over 65 years old, and among men and women aged 80 years and older - 4-6% and 8-10%, respectively [ 7, 9, 11 ]. Statistical reports indicate a stable trend towards an increase in the general population incidence of CHF with preserved LV EF (approximately 1% per year), which may lead to a change in the phenotype of heart failure as such in the coming decades [8, 10, 12]. The leading role of hypertension in the occurrence of CHF with normal LV contractility has been firmly proven [13, 15, 17]. The presence of systemic hypertension in history was noted in the vast majority (>80%) of patients with CHF, whose left ventricular ejection fraction was ≥50% [14, 16, 18].