2 articles
Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of all heart failure cases and is frequently associated with cardiovascular and metabolic comorbidities. The phenotype of HFpEF patients is heterogeneous, and the impact of comorbidities on prognosis, exercise capacity, and functional status remains insufficiently elucidated.
The study aimed to characterize the clinical, functional, and comorbidity profiles of patients with HFpEF and to assess their influence on functional status, prognosis, and treatment response.
This was an observational, cross-sectional study including 206 patients with HFpEF (LVEF ≥50%) consecutively recruited from the General Cardiology Department of the Institute of Cardiology, aged ≥18 years, with an echocardiographically confirmed diagnosis. Demographic and anthropometric data, HFpEF etiology, hemodynamic biomarkers (NT-proBNP), functional status (NYHA), cardiovascular and non-cardiovascular comorbidities, and history of revascularization procedures (PCI, coronary bypass) were collected. Statistical analysis included descriptive statistics for continuous variables (mean ± SD, median, IQR), categorical variables (frequencies and percentages), and parametric/nonparametric tests for correlations and subgroup analyses, with statistical significance set at P < 0.05.
The study population showed a typical overweight/obese profile, with arterial hypertension and chronic coronary artery disease as predominant mechanisms. Cardiovascular and metabolic comorbidities influenced exercise capacity, functional status, and treatment response, identifying distinct phenotypic subgroups with differential prognostic impact. Elevated NT-proBNP levels reflected increased ventricular filling pressures and functional heterogeneity, underscoring the need for individualized management.
HFpEF is associated with a complex clinical profile dominated by hypertension, coronary artery disease, and metabolic comorbidities. Detailed assessment of comorbidities and biomarkers allows patient phenotyping and personalized therapeutic management. A multidisciplinary approach is essential for optimizing prognosis, exercise capacity, and quality of life in patients with HFpEF.
Chronic obstructive pulmonary disease (COPD) is considered an important disease in the structure of morbidity and mortality and a rising public health problem with increasing global age prevalence. Exacerbation of COPD in the elderly has a significant negative impact on the clinical and paraclinical picture, daily activity capacity, and quality of life. The need for correct diagnostic management is dictated by the severity of the pathology in the elderly and the high frequency of cardiac complications. Studying the clinical-paraclinical picture and the diagnostic capacity of natriuretic peptides in COPD patients with cardiovascular complications was the aim of the present research.
We conducted an analytical, observational, case-control study with the use of modern research methods. The study included 194 elderly patients (≥ 65 years old) divided into two study groups: those with only COPD (COPD group) and those with associated pulmonary hypertension (PHCOPD group). Patients underwent clinical, paraclinical, and functional investigation methods with subsequent mathematical-statistical data processing.
The study groups were similar according to socio-demographic data. The clinical assessment revealed that PHCOPD patients had, in comparison with COPD patients, statistically significantly more frequent and severe complaints. The objective examination determined that in PHCOPD patients, the values of the objective examination indices were much more affected than in the COPD group. At the complex geriatric assessment, the COPD group of patients shows a lower degree of dependence and less cognitive impairment. The multidimensional assessment of COPD reflected more severe impairment according to the CAT, SGRQ, CCQ, mMRC, BODE questionnaires, and 6MWT test in the PHCOPD group compared to the COPD group. Spirographic, radiographic, ultrasonographic, and echocardiographic evaluations correlated with age, inflammatory syndrome, and natriuretic peptide level.
The PHCOPD group patients present a clinical picture, exercise capacity, objective data, complex geriatric assessment scores, and a multidimensional assessment of COPD that is statistically more frequent and severely affected compared to the COPD group. The impact of hemodynamic disturbances in COPD could be confirmed by the correlation of paraclinical data, such as the inflammatory response syndrome, increased natriuretic peptides, echocardiography data, and indices of internal organ ultrasound examination.