Area of Science:

• Cardiology
• Geriatrics
• Internal Medicine

Background:

• Bendopnea is a symptom of dyspnea experienced upon bending forward.
• Its prevalence and prognostic significance in elderly patients with chronic heart failure (CHF) require further investigation.

Purpose of the Study:

• To determine the prevalence of bendopnea in ambulatory elderly patients with CHF.
• To assess the association of bendopnea with clinical, laboratory, and echocardiographic features.
• To evaluate the impact of bendopnea on clinical outcomes over a 2-year follow-up period.

Main Methods:

• An open, prospective, non-randomized study was conducted on 80 ambulatory elderly patients (≥60 years) with CHF (NYHA class II-IV).
• Data collected included physical examination, Charlson comorbidity index, echocardiography, laboratory tests, and assessment of bendopnea (onset within 30 seconds of bending forward).
• Patients were followed for a mean of 26.6 months for clinical outcomes, including mortality and hospitalizations.

Main Results:

• Bendopnea was present in 38.8% of patients and was significantly associated with male gender, clinical severity (SHOCK scale), higher Charlson comorbidity index, coronary heart disease, myocardial infarction history, left ventricular (LV) aneurysm, increased LV end-systolic diameter and volume, larger left atrial size, elevated pulmonary artery systolic pressure, and higher NT-proBNP, creatinine, and uric acid levels.
• Multifactorial analysis confirmed associations with clinical severity, increased left atrial size, and Charlson comorbidity index.
• Mortality during follow-up was significantly higher in patients with bendopnea (51.6%) compared to those without (12.2%).

Conclusions:

• Bendopnea is a prevalent symptom in elderly patients with chronic heart failure.
• The presence of bendopnea is linked to an adverse hemodynamic profile and predicts a poorer prognosis.
• Bendopnea can be considered a reliable clinical marker for assessing the severity of chronic heart failure.