PROGNOSTIC VALUE OF LEFT ATRIAL FUNCTIONAL PARAMETERS IN PATIENTS WITH SEVERE CHRONIC HEART FAILURE AND PRESERVED LEFT VENTRICULAR SYSTOLIC FUNCTION

The aim of study was to assess prognostic significance of left atrial (LA) functional parameters and levels of biomarkers in patients (pts) with severe chronic heart failure (CHF) and preserved left ventricular (LV) systolic function. Methods. Prognostic value of LA functional parameters, levels of BNP., NT-proBNP and high sensitivity C reactive protein (CRP) was assesed in 128 pts (age 63.2±1.7) with III-IV NYHA functional calss CHF and preserved LV systolic function (LV EF >50%). Results. During 37±0.8 months from cardiac causes died 43 (33.6%) pts. In Kaplan-Mayer analisys survival rate was 62, 63 и 64% in pts with levels of BNP >300 pg/ml, NT-proBNP ≥1500 pg/ml and CRP≥15 ng/ml and 85, 86 и 84% (p<0.01) in pts with levels of BNP<300 pg/ml, NT-proBNP<1500 pg/ml and CRP<15 ng/ml. Similar survival (p<0.01) was revealed in pts with LAKE≥40 kdyn/sm/sec (87%), EFakt≥25% (82%), LAF≥0.4 (86%), FAC≥50 (84%), PVSC≥60% (87%), S/D fraction≥55% (83%), Аrdur≤150 msec 30 msec (87%) compared to pts with LAKE<40 kdyn/sm/sec (62%), EFakt<25% (65%), LAFI<0.4 (63%), FAC<50 (65%), PVSC<60% (63%), S/D fraction<55% (63,5%), Аrdur>150 msec (63%) и Ar-A>-30 msec (62%), respectively. Conclusions: 1) LA functional parameters are powerfull independent predictors in pts with CHF and preserved LV systolic function. 2) Distribution of pts according to baseline levels of BNP <300 and ≥300 pg/ml, NT-pro-BNP <1500 and ≥1500 pg/ml and hsCRP <15 and ≥15 ng/ml allowed to identify (p<0.01) pts with low and high risk of cardias death.

хроническая сердечная недостаточность, прогноз, левое предсердие, легочные вены, диастолическая функция, мозговой натрийуретический пептид, NT-промозговой на-трийуретический пептид высокочувствительный С-реактивный белок, chronic heart failure, prognosis, left atrium, pulmonary vein, diastolic function, BNP, NT-proBNP, high sensitivity C reactive protein, ivabradine

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