Bidzilya P. Clinical, pathogenetic and prognostic aspects, diagnosis and treatment of chronic heart failure in patients with overweight and obesity.

The thesis is devoted to improving the quality of diagnosis, effectiveness of treatment and prognosis of chronic heart failure with preserved left ventricular ejection fraction (CHFprEF) in patients with overweight and obesity, based on the study of clinical features of the disease, structural and functional changes of the heart, markers of adipocytokines, immunoinflammatory metabolism, indicators of carbohydrate, lipid spectra and the development of optimization ways for medication therapy. It has been found, that more unfavorable course of CHFprEF in patients with overweight, ischemic genesis and mild decreased LV EF observed. Cardiac remodeling in excess weight are presented with more pronounced concentric LV hypertrophy, the degree of which increases with the elevation of body mass index (BMI). In BMI increase the adiponectin decreases, and the resistin increases. In patients with CHFprEF with excess weight negative prognostic value of serum content of adiponectin >31.5 μg / ml and resistin >16.99 ng / ml was discovered, the risk of cumulative end-points (CEP) and five-year mortality reduced when β-AB and statins are used, while β-AB and ARB demonstrate decreasing of the re-hospitalization risk. In patients with ischemic etiology CHFprEF the risk of CEP, cardiovascular, other types of death and re-hospitalization decreases by treatment with β-AB and amlodipine (when combined with arterial hypertension). In patients with mild decreased LV EV administration of β-AB and statins reduces the risk of CEP and death, and in normal LV EF – five-year mortality.