Predictors of mortality in patients with chronic heart failure at the outpatient stage
https://doi.org/10.34215/1609-1175-2025-2-61-67
Abstract
Objective. To assess the factors influencing mortality over a one-year follow-up period in outpatients with chronic heart failure and with preserved and mildly reduced left ventricular ejection fraction. Materials and methods. An open prospective controlled non-randomized study included 292 patients who were followed in the City Polyclinic No. 8, Tyumen, Russia, during 2021–2024. A total of 89 parameters were assessed, characterizing heart failure (severity of structural heart abnormalities, left ventricular ejection fraction, six-minute walk test, NT-proBNP levels and their dynamics); comorbid conditions; pharmacotherapy; vaccination status during the study period; and psycho-emotional characteristics (scores on the Hospital Anxiety and Depression Scale [HADS], Morisky-Green test, Type D personality assessment [DS-14], self-care ability according to the EHFScBS-9 questionnaire, and self-assessed cognitive impairment using the McNair and Kahn scale). Results. In the group of deceased patients, a higher body mass index (p = 0.034), higher Charlson comorbidity index score (p = 0.001), and higher self-care score (p = 0.015) were observed, along with a slightly lower baseline six-minute walk test result in meters (p = 0.065). A binary logistic regression prognostic model was developed based on the analysis of mortality causes during the follow-up period. For continuous variables identified as significant factors, ROC analysis was performed. Conclusion. A subgroup of patients with chronic heart failure and with preserved and mildly reduced ejection fraction was identified as having an increased risk of mortality during the one-year outpatient follow-up period. This group included patients with NYHA functional class III–IV heart failure, obesity, a Charlson comorbidity index score greater than 4, reduced self-care ability, and Type D personality
About the Authors
S. Y. Volkova
Tyumen State Medical University
Russian Federation
Russian Federation
Svetlana Yu. Volkova, Dr. Sci. (Med.), Associate Professor, Professor of Department of Hospital Therapy with Endocrinology
54 Odesskaya St., 625023, Tyumen
M. N. Alyokhina
Tyumen State Medical University; City Polyclinic No. 8
Russian Federation
Russian Federation
54 Odesskaya St., 625023, Tyumen
E. A. Boyarskaya
Tyumen State Medical University
Russian Federation
Russian Federation
54 Odesskaya St., 625023, Tyumen
References
1. Gavryushina SV, Ageev FT. Heart failure with preserved left ventricular ejection fraction: epidemiology, patient portrait, clinic and diagnostics. Kardiologiia. 2018;58(S4):55–64 (In Russ.) doi: 10.18087/cardio.2467
2. Powell-Wiley T, Ngwa J, Kebede S, Lu D, Schulte P, Bhatt D, Yancy C, Fonarow G, Albert M. Impact of Body Mass Index on Heart Failure by Race/Ethnicity From the Get With The Guidelines – Heart Failure (GWTG–HF) Registry. JACC: Heart Failure. 2018;6(3):233–242. doi: 10.1016/j.jchf.2017.11.011
3. Crespo-Leiro M, Anker S, Maggioni A, Coats A, Filippatos G, Ruschitzka F, Ferrari R, Piepoli M, Jimenez J, Metra M, Fonseca C, Hradec J, Amir O, Logeart D, Dahlström U, Merkely B, Drozdz J, Goncalvesova E, Hassanein M, Chioncel O, Lainscak M, Seferovic P, Tousoulis D, Kavoliuniene A, Fruhwald F, Fazlibegovic E, Temizhan A, Gatzov P, Erglis A, Laroche C, Mebaza A. European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomesand differences across regions. Eur J Heart Fail. 2016;18(6):613–625. doi: 10.1002/ejhf.566
4. Sumin AN, Raykh OI, Indukaeva EV, Artamonova GV. Prevalence of type D personality and its association with cardiovascular diseases and their risk factors according to the esse study conducted in Kemerovo region. Rational Pharmacotherapy in Cardiology. 2015;11(3):261–266. (In Russ.) doi: 10.20996/1819-6446-2015-11-3-261-266
5. Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo-Leiro M, Harjola V, Parissis J, Laroche C, Piepoli MF, Fonseca C, Mebazaa A, Lund L, Ambrosio GA, Coats AJ, Ferrari R, Ruschitzka F, Maggioni AP, Filippatos G. Epidemiology and oneyear outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2017;19:1574–1585. doi: 10.1002/ejhf.813
6. Polyakov DS, Fomin IV, Belenkov YuN, Mareev VYu, Ageev FT, Artemjeva EG, Badin YuV, Bakulina EV, Vinogradova NG, Galyavich AS, Ionova TS, Kamalov GM, Kechedzhieva SG, Koziolova NA, Malenkova VYu, Malchikova SV, Mareev YuV, Smirnova EA, Tarlovskaya EI, Shcherbinina EV, Yakushin SS. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021;61(4):4–14 (In Russ.) doi: 10.18087/cardio.2021.4.n1628
7. Inacio H, De Carvalho A, De Carvalho CJ, Maia A, Durão-Carvalho G, Duarte J, Rodrigues C, Araújo I, Henriques C, Fonseca C. Real-Life Data on Readmissions of Worsening Heart Failure Outpatients in a Heart Failure Clinic. Cureus. 2023;15(2): e35611. doi: 10.7759/cureus.35611
8. Airapetian AA, Lazareva NV, Reitblat OM, Mezhonov EM, Sorokin EV, Prints YuS, Zhirov IV, Tereshchenko SN, Boytsov SA. Comorbid conditions in patients with chronicheart failure (according to the registry of chronic heart failure in the Tyumen region). Consilium Medicum. 2023;25(10):685–92 (In Russ.) doi: 10.26 442/20751753.2023.10.202384
9. Shlyakhto EV, Belenkov YuN, Boytsov SI, Villevalde SV, Galyavich AS, Glezer MG, Zvartau NE, Kobalava Zh, Lopatin YuM, Mareev YuV, Tereshchenko SN, Fomin IV, Barbarash OL, Vinogradova NG, Duplyakov DV, Zhirov IV, Kosmacheva ED, Nevzorova VA, Reitblat OM, Soloveva AE, Zorina EA. Prospective observational multicenter registry study of patients with heart failure in the Russian Federation (PRIORITET-CHF): rationale, objectives and design of the study. Russian Journal of Cardiology. 2023;28(6):5456 (In Russ.) doi: 10.15829/1560-4071-2023-5456
10. Haass M, Kitzman DW, Anand IS, Miller A, Zile MR, Massie BM, Carson PE. Body mass index and adverse cardiovascular outcomes in heart failure patients with preserved ejection fraction: results from the irbesartan in heart failure with preserved ejection fraction (I-PRESERVE) trial. Circ Heart Fail. 2011;4:324–31. doi: 10.1161/CIRCHEARTFAILURE.110.959890
11. Gioeva ZM, Bogdanov AR, Zaletova TS, Bogdanova AA. Obesity as a risk factor for chronic heart failure: a review of the literature. Doctor.Ru. 2017;10(139):21–25 (In Russ.)
12. Boytsov SA, Ageev FT, Blankova ZN, Svirida ON, Begrambekova YuL. Guidelines for nurses and patients with chronic heart failure. Cardiovascular Therapy and Prevention. 2021;20(1):2754 (In Russ.) doi: 10.15829/1728-8800-2021-2754
13. Lopatin YuM, Grebennikova AA, Begrambekova YuL. Reliability and discriminant validity of the Russian version of European self-care behaviour scale in chronic heart failure. Russian Journal of Cardiology. 2016;(8):14–19 (In Russ.) doi: 10.15829/1560-4071-2016-8-14-19
14. Calero-Molina E, Hidalgo E, Rosenfeld L, Verdú-Rotellar JM, Verdú-Soriano J, Garay A, Alcoberro L, Jimenez-Marrero S, Garcimartin P, Yun S, Guerrero C, Moliner P, Delso C, Alcober L, Enjuanes C, Comin-Colet J. The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study. Eur J Cardiovasc Nurs. 2022 Mar 3;21(2):116–126. doi: 10.1093/eurjcn/zvab011
15. Kessing D, Denollet J, Widdershoven J, Kupper N. Psychological Determinants of Heart Failure Self-Care: Systematic Review and Meta-Analysis. Psychosom Med. 2016;78(4):412–31. doi: 10.1097/PSY.0000000000000270
Review
For citations:
Volkova S.Y., Alyokhina M.N., Boyarskaya E.A. Predictors of mortality in patients with chronic heart failure at the outpatient stage. Pacific Medical Journal. 2025;(2):61-67. (In Russ.) https://doi.org/10.34215/1609-1175-2025-2-61-67
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