[THE PROGNOSTIC VALUE OF OBESITY AND HYPONATERMIA IN PROGRESSING OF CHRONIC HEART FAILER: CARDIOVASCULAR MORTALITY...

Aim - to study the predictors of cardiovascular events in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction role of traditional and non-traditional risk factors, to analyze the prognostic role of hyponatremia. Analysis of the clinical features of CHF was provided by retrospective research of medical cards in 308 patients, with endpoint verification during long-term period from 2010 to 2015. Among the examined patients 81 addmitted to the intensive care unit. The study showed that in obesity patients with body mass index (BMI) more than 30 kg/m2, the incidence of CHF decompensation was higher (p<0,05), but a significant mortality in CHF is only possible with abdominal obesity. It was proved the significant increase of CHF decompensation at patients with diabetes mellitus (p<0,05), the gender specificity of the disease was the higher risk of cardiovascular mortality in males (p<0,05).It was found that the most often in patients with CHF decompensation was reduced systolic pressure with an absolute risk of 82,7%. It was established a significantly higher risk of cardiovascular mortality in CHF with a sodium level less than 135 mmol/l, an increase from 19,0 to 45,0%, the "cut-off point" was established at the Na+ level between 115.0-125.0 mmol/l. After analyzing of the "combined" risk with hyponatremia and obesity, cardiovascular mortality increased to 23,0%.In the group with severe decompensation of CHF, it was set the lower hemoglobin level (p<0,05), lower hematocrit (p<0,05), higher ESR (p<0,05) and total leukocyte count(p<0,05).Absolute risk of cardiovascular mortality with hemoglobin level before 120 g/l was 48,0% vs. 16,0% of patients with normal hemoglobin level. Significant factors, combined with frequent hospitalization were age over 65 years (p<0,05), body mass index more than 30 kg/m2 (p<0,05), III and IV functional classes of CHF (p<0,05),hemoglobin level less than 120 g/l (p<0,05), hyponatremia (p<0,05).It was set the reliable influence of combined hyponatremia and obesity on the frequency of hospitalizations in CHF patients with an increase of absolute risk with 55,0%, reliable RR and OR (p<0,05).