Prognostic value of GDF levels 15 and NTproBNP and echocardiographic parameters in patients with heart failure with preserved ejection fraction, after myocardial infarction on the background of hypertension according to the three-year observation
DOI:
https://doi.org/10.14739/2310-1210.2016.5.82548Keywords:
Heart Failure, Growth Differentiation Factor 15, Myocardial Infarction, HypertensionAbstract
Chronic heart failure with preserved ejection fraction refers to syndromes with a poor prognosis.
The aim - to evaluate the long-term prognosis in patients with heart failure with preserved ejection fraction after myocardial infarction on the background of hypertension, according to the risk of fatal and non fatal cardiovascular events during the three-year observation.
Materials and methods. The study involved 62 patients (50 men and 12 women) with heart failure with preserved ejection fraction after myocardial infarction on the background of hypertension with comorbid hypertension (mean age 64±1 years old). Observation of patients was conducted for three years. As clinical endpoints are the overall mortality and mortality from cardiovascular events, myocardial infarction and re-hospitalization due to heart failure decompensation registered within three years after signing the informed consent. Assessment of intracardiac hemodynamics conducted by echocardiography on apparatus "VIVID 3 Expert" ("General Electric", USA) by the standard method using tissue Doppler. Levels GDF 15 and NTproBNP in serum were determined using ELISA kits of reagents Human GDF-15 / MIC-1 ELISA («BioVendor», Czech Republic) and NT-proBNP ELISA Kit («Biomedica», Slovakia).
Results. Overall mortality among patients with heart failure with preserved ejection fraction after myocardial infarction on the background of hypertension at the observation period was 12,9% (8 patients). With cardiovascular disease was associated 9,7% of deaths (6 patients). In 24,2% of patients (15 patients) was registered decompensated heart failure requiring hospitalization. Predictive potential for occurrence of fatal events according to the three-year observation had 15 GDF (RR = 9,85; 95% CI = 2,83-34,07; p<0.05), NTproBNP (RR = 6,30; 95% CI = 1,39-28,49; p<0.05) and E/E' (RR = 4.05; 95% CI = 1,19-13,77; p<0.05). Prognostic significance for occurrence of non-fatal cardiovascular events according to the three-year observation had GDF 15 (RR = 4,54; 95% CI = 2,41-8,57, p<0.05) and the ratio of E/E' (RR = 2,25; 95% CI = 1,47-3,44, p<0.05).
Conclusions. To predict the occurrence of fatal and nonfatal cardiovascular events in patients with heart failure with preserved ejection fraction after myocardial infarction on the background of hypertension the highest predictive significance had GDF 15 and E/E'.
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