Analysis of comorbidity in patients with chronic left ventricular failure

The mechanisms of chronic heart failure (CHF) development and the factors causing left ventricular dysfunction are of great scientific and practical interest in terms of effective prevention of CHF and its progression. Purpose of the work: In a observational retrospective study, an analysis of the frequency and spectrum of comorbid pathology in patients with chronic left ventricular failure (CLVF) was conducted in term to investigate the association of non-cardiovascular comorbidity and CLVF. Materials and methods: The study included 1,223 patients hospitalized for heart failure in the therapeutic profile departments of the State Healthcare Institution "Clinical Hospital of Emergency Medical Assistance No. 7" in Volgograd from 2015 to 2024. When analyzing non-cardiovascular comorbid pathology, the presence of the most common diseases of internal organs and the endocrine system was considered: chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), obesity, and metabolic syndrome (MetS). The objectives of the study were to investigate the frequency and spectrum of non-cardiovascular comorbidity in patients with heart failure, analyze the relationship between the age of patients with CLVF and the frequency of comorbid conditions, determine the predominant type of CLVF in different age groups, and assess the impact of non-cardiovascular comorbidity on the type and severity of CLVF. Results and discussion: The study showed that the overwhelming majority of patients with CLVF (1,088 people – 88.96 %) had comorbid pathology of internal organs or the endocrine system, with 884 (72.28 %) of them diagnosed with non-cardiovascular comorbidity. The results confirmed an association between age and the presence of comorbid conditions, with the highest frequency of associated diseases observed in the older age group. It was established that among patients without studied comorbidities, heart failure with preserved ejection fraction (HFpEF) and class I functional class (FC I) predominated, whereas patients with comorbid pathology more often belonged to functional classes II–IV and had heart failure with reduced ejection fraction (HFrEF). Statistical analysis using the concordance criterion confirmed a significant relationship between age, functional class of HF, ejection fraction indicators on the one hand, and the presence of non-cardiovascular comorbidity on the other. Correlation analysis revealed a strong positive correlation between functional class and comorbidity, indicating a linear dependence between the presence of comorbid diseases and the severity of CLVF. Conclusion: Thus, the results of the study confirm the important role of non-cardiovascular comorbidity in the development and clinical manifestation of chronic left ventricular failure.