Lazidi K. Optimization of prognosis in patients with ischemic heart failure and obesity based on investigation of hyponatremia and natriuretic peptide level.

In thesis was conducted the research of clinical and prognostic value of hyponatremia and natriuretic peptide in patients with chronic heart failure (HF) and preserved ejection fraction (HFpEF) with concominant obesity. For this goal from 2015 to 2018 were conducted 2 types of clinical trials. The first study was prospective clinical observation of 176 people, including 146 patients with chronic heart failure and 30 healthy individuals. The patients were divided into groups: group 1 - HFpEF and body mass index (BMI) < 25 kg/m2 (40 persons, 27,%), group 2 - HFpEF and BMI 25-30 kg/m2 (35 persons, 24,0%), group 3 - HFpEF and BMI >30 kg/m2 (71 persons, 48,6%). The second type of research was retrospective, based on the analysis of medical cards of 217 patients with chronic heart failure. In the dissertation the clinical and prognostic values of hyponatremia and brain natriuretic peptide were evaluated in patients with chronic heart failure and preserved ejection fraction on the background of accompanying obesity. We recommend to determine the level of ionized sodium for predicting the risk of hospitalizations and cardiovascular events in routine method in patients with HF. Prognostically unfavorable was the sodium level less than 135 mmol/l, for fatal cardiovascular events - 115-125 mmol/l. It is recommended to determine the level of aldosterone and NTproBNP. Prognostically unfavorable was the level of NTproBNP 587,2±225,6 pg/ml, which is associated with a reduction in CRF and level of aldosterone 130,2 pmol/l, which is associated with severe hyponatremia.