OBJECTIVE

To estimate the pentraxin-3 (PTX-3) level in patients with functional class (FC) (NYHA) II—IV ischemic chronic heart failure (CHF), to identify possible relationship with associated metabolic syndrome (MS) and clinical course.

MATERIAL AND METHODS

180 patients with FC II—IV ischemic CHF were examined (90 with MS, and 90 without MS). At the time of inclusion in the study the age of patients in the MS group was 56 [46; 63] years, in the group without MS — 59.5 [51; 70] years. All patients underwent the comprehensive examination including complaints registration, medical history study, physical examination, anthropometric measurements, laboratory and instrumental examination including PTX-3 level.

RESULTS

In the group of patients with CHF and MS, compared with the group with CHF and without MS, there are people predominate with burdened hereditary history of CVD (50% vs 34%), arterial hypertension (38% vs 24%), higher body mass index (30.4 [27.9; 35] kg/m² vs 24.5 [23; 27] kg/m²), higher severity of dyspnea (67% during exercise and 32% at rest vs 64% during exercise and 24% at rest), higher frequency of increase in body weight over past week (44% versus 19%), higher glucose level (6.0 [5.4; 6.7] vs 5.0 [4.7; 5.2] and lower creatinine level (85 [71; 99] vs 87 [74; 121]) (p<0.05). Patients with CHF and MS compared with patients with CHF and without MS have more severe structural myocardial remodeling. The average PTX-3 level in patients with CHF and MS is 79 ng/ml, without MS —98 ng/ml (p=0.924). In patients with CHF and MS the PTX-3 level showed statistically significant correlation with the value of left ventricle ejection fraction (LVEF) (r= –0.281) and size of LV (r=0.198), higher score of Clinical Assessment Scale (CAS) modified by V.Y. Mareev (r=0.246) and lower six-minute walking test (6MWT) score (r= –0.297; p<0.05). In patients with CHF without MS, the PTX-3 level showed statistically significant correlation with the values of LVEF (r= –0.187) and size of LV (r=0.192), higher CAS score (r=0.232) and lower 6MWT score (r= –0.196), higher severity of swelling (r=0.175), severity of dyspnea (r=0.135) and dyspnea in lying position (r=0.126; p<0.05).

CONCLUSION

In clinical trials of patients with FC II-IV (NYHA) ischemic CHF, it is advisable to estimate the PTX-3 concentration as the factor associated with its adverse course. It is advisable to take into consideration the likely influence of MS on the PTX-3 level when performing studies of its prognostic significance in relation to CVD.