Elastic moments of arteries in patients with chronic heart failure: Visceral obesity influence


DOI: https://dx.doi.org/10.18565/therapy.2024.4.34-40

Statsenko M.E., Derevyanchenko M.V., Fabritskaya S.V., Shilina N.N.

Volgograd State Medical University of the Ministry of Healthcare of Russia
Abstract. Obesity still remains to be a pressing problem in modern medicine due to its high prevalence, steady growth and high comorbidity with cardiovascular pathology, including chronic heart failure (CHF). Obesity increases the risk of CHF developing by more than 50%. Combination of CHF and obesity has a mutually aggravating adverse effect on target organs (heart, kidneys, blood vessels).
The aim: to evaluate the effect of visceral obesity at the elastic moments of arteries in CHF patients.
Material and methods. 191 patient aged 45–70 years with stage I–IIA CHF, I–III functional class was examined. All patients were divided into 2 groups depending on body mass index (BMI): 1st – patients with CHF without obesity (n = 110), 2nd – with CHF and obesity of 1–2nd degree (n = 81). All participants underwent a clinical examination, calculation of BMI, measurements of waist circumference (WC), hip circumference (HC), WC/HC calculation, visceral fat percentage, assessment of epicardial adipose tissue thickness (ETAT) using echocardiography, pulse wave velocity through elastic and muscular vessels type (PWVe and PWVm).
Results. In the group of patients with CHF and obesity, the values of BMI, WC, WC/HC, subcutaneous and visceral fat indexes, as well as the number of patients with abdominal and visceral obesity were naturally higher than in the group of patients having CHF without obesity (p < 0.05). Among patients of group 2, comparatively to patients of group 1, a significant increase in ETAT, as well as an increase in PWVe, were fixed (10.7 [9.1; 11.3] vs. 8.7 [7.5; 8.4] m/s). ROC analysis revealed the quantitative values of the studied parameters (cut-off points), upon reaching and exceeding which an increase in cardiovascular risk is predicted in the form of an increase in PWVe of more than 10 m/s: visceral fat – 11.5%, ETAT – 6.65 mm, WC/HC ratio – 0.895.
Conclusion. It is advisable to recommend PWVe determination in cases when quantitative values of visceral fat are ≥ 11.5%, ETAT ≥ 6.65 mm, WC/HC ratio ≥ 0.895 are taking place in patients with CHF and obesity.
Keywords: elasticity of the main arteries, epicardial adipose tissue, visceral obesity, pulse wave velocity, chronic heart failure
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Literature

1. Kontsevaya A., Shalnova S., Deev A. et al. Overweight and obesity in the Russian population: Prevalence in adults and association with socioeconomic parameters and cardiovascular risk factors. Obesity Facts. 2019; 12(1): 103–14.


https://doi.org/10.1159/000493885. PMID: 30844809. PMCID: PMC6465691.


2. Драпкина О.М., Шепель Р.Н. Оценка уровня физической активности у пациентов с избыточной массой тела и ожирением в Российской Федерации (ФАКТОР-РФ): обоснование и дизайн исследования. Профилактическая медицина. 2020; 23(3): 7–19. (Drapkina O.M., Shepel R.N. Assessment of the level of physical activity in patients with overweight and obesity in the Russian Federation (FACTOR-RF): Argumentation and study design. Profilakticheskaya meditsina = Russian Journal of Preventive Medicine. 2020; 23(3): 7–19 (In Russ.)).


https://doi.org/10.17116/profmed2020230317. EDN: WOEUGB.


3. Гриценко О.В., Чумакова Г.А., Груздева О.В., Субботин Е.А. Возможности управления риском развития диастолической дисфункции левого желудочка у больных с ожирением. Российский кардиологический журнал. 2023; 28(4): 32–37. (Gritsenko O.V., Chumakova G.A., Gruzdeva O.V., Subbotin E.A. Possibilities for managing the left ventricular diastolic dysfunction risk in obese patients. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2023; 28(4): 32–37 (In Russ.)).


https://doi.org/doi:10.15829/1560-4071-2023-5363. EDN: RUHHDH.


4. Дедов И.И., Шестакова М.В., Мельниченко Г.А. с соавт. Междисциплинарные клинические рекомендации «Лечение ожирения и коморбидных заболеваний». Ожирение и метаболизм. 2021; 18(1): 5–99. (Dedov I.I., Shestakova M.V., Melnichenko G.A. et al. Interdisciplinary clinical practice guidelines “Management of obesity and its comorbidities”. Ozhirenie i metabolizm = Obesity and Metabolism. 2021; 18(1): 5–99 (In Russ.)).


https://doi.org/10.14341/omet12714. EDN: AHSBSE.


5. Elagizi A., Kachur S., Carbone S. et al. A review of obesity, physical activity and cardiovascular disease. Curr Obes Rep. 2020; 9(4): 571–81.


https://doi.org/10.1007/s13679-020-00403-z. PMID: 32870465.


6. Маматов А.У., Орозматов Т.Т., Мадаминов Ж.Б. с соавт. Ожирение и риск развития сердечно-сосудистых заболеваний: взгляд на современную проблему. The Scientific Heritage. 2021; (64–2): 35–42. (Mamatov A.U., Orozmatov T.T., Madaminov Zh.B. et al. Obesity and the risk of developing cardiovascular diseases: A look at the current problem. The Scientific Heritage. 2021; (64–2): 35–42 (In Russ.)).


https://doi.org/10.24412/9215-0365-2021-64-2-35-42. EDN: VXRHMO.


7. Стаценко М.Е., Деревянченко М.В. Влияние висцерального ожирения на эластичность магистральных артерий и сосудистый возраст у больных артериальной гипертензией, ожирением и сахарным диабетом 2 типа. Российский кардиологический журнал. 2021; (26)4: 9–16. (Statsenko M.E., Derevyanchenko M.V. The effect of visceral obesity on the elasticity of the main arteries and vascular age in patients with hypertension, obesity and type 2 diabetes mellitus. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2021; (26)4: 9–16 (In Russ.)).


https://doi.org/10.15829/1560-4071-2021-4466. EDN: ANECUF.


8. Стаценко М.Е., Деревянченко М.В., Фабрицкая С.В. с соавт. Роль висцерального ожирения в прогрессировании ригидности магистральных артерий у больных хронической сердечной недостаточностью. Терапия. 2023; 9(71): 70–79. (Statsenko M.E., Derevyanchenko M.V., Fabritskaya S.V. et al. The role of visceral obesity in the progression of arterial stiffness in patients with chronic heart failure. Terapiya = Therapy. 2023; 9(71): 70–79 (In Russ.)).


https://doi.org/10.18565/therapy.2023.9.70-78. EDN: GBKOHS.


9. Драпкина О.М., Дадаева В.А. Жесткость сосудистой стенки при хронической сердечной недостаточности. Клиницист. 2013; 7(3–4): 27–30. (Drapkina O.M., Dadaeva V.A. Vascular wall stiffness in chronic heart failure. Klinitsist = The Clinician. 2013; 7(3–4): 27–30 (In Russ.)). EDN: SHUGOT.


10. Weber T. The role of arterial stiffness and central hemodynamics in heart failure. Int J Heart Fail. 2020; 2(4): 209–30.


https://doi.org/10.36628/ijhf.2020.0029. PMID: 36262174. PMCID: PMC9536727.


11. Omboni S., Bulanova N., Posokhov I. et al.; VASOTENS Registry Study Group. Variable association of 24-h peripheral and central hemodynamics and stiffness with hypertension-mediated organ damage: The VASOTENS registry. J Hypertens. 2020; 38(4): 701–15.


https://doi.org/10.1097/HJH.0000000000002312. PMID: 31834122.


12. Стаценко М.Е., Деревянченко М.В. Состояние магистральных артерий, сосудистый возраст у больных артериальной гипертензией и ожирением: роль лептина и адипонектина. Российский кардиологический журнал. 2019; 24(1): 7–11. (Statsenko M.E., Derevyanchenko M.V. The state of the main arteries, vascular age in patients with arterial hypertension and obesity: The role of leptin and adiponectin. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2019; 24(1): 7–11 (In Russ.)).


https://doi.org/10.15829/1560-4071-2019-1-7-11. EDN: YWYOQX.


13. Клинические рекомендации. Ожирение. Российская ассоциация эндокринологов, Общество бариатрических хирургов. Рубрикатор клинических рекомендаций Минздрава России. 2020. ID: 28. Доступ: http://cr.rosminzdrav.ru/schema/28_1 (дата обращения – 01.05.2024). (Clinical guidelines. Obesity. Russian Association of Endocrinologists, Society of Bariatric Surgeons. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2020. ID: 156. URL: http://cr.rosminzdrav.ru/schema/156_1 (date of access – 01.05.2024) (In Russ.)).


14. Клинические рекомендации. Хроническая сердечная недостаточность. Российское кардиологическое общество, автономная некоммерческая организация «Национальное общество по изучению сердечной недостаточности и заболеваний миокарда», общероссийская общественная организация «Общество специалистов по сердечной недостаточности». Рубрикатор клинических рекомендаций Минздрава России. 2020. ID: 156. Доступ: http://cr.rosminzdrav.ru/schema/156_1 (дата обращения – 01.05.2024). (Clinical guidelines. Chronic heart failure. Russian Society of Cardiology, National Society for the Study of Heart Failure and Myocardial Diseases, Society of Heart Failure Specialists. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2020. ID: 156. URL: http://cr.rosminzdrav.ru/schema/156_1 (date of access – 01.05.2024) (In Russ.)).


15. Дедов И.И., Мокрышева Н.Г., Мельниченко Г.А. с соавт. Ожирение. Клинические рекомендации. Consilium Medicum. 2021; 23(4): 311–325. (Dedov I.I., Mokrysheva N.G., Melnichenko G.A. et al. Obesity. Clinical recommendations. Consilium Medicum. 2021; 23(4): 311–325 (In Russ.)).


https://doi.org/10.26442/20751753.2021.4.200832. EDN: GYUVLJ.


16. Давыдова А.В., Никифоров В.С., Халимов Ю.Ш. Толщина эпикардиальной жировой ткани как предиктор кардиоваскулярного риска. Consilium Medicum. 2018; 20(10): 91–94. (Davydova A.V., Nikiforov V.S., Khalimov Yu.Sh. Thickness of epicardial adipose tissue as a predictor of cardiovascular risk. Consilium Medicum. 2018; 20(10): 91–94 (In Russ.)).


https://doi.org/10.26442/2075-1753_2018.10.91-94. EDN: VAKFZS.


17. Кобалава Ж.Д., Конради А.О., Недогода С.В. с соавт. Артериальная гипертензия у взрослых. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 25(3): 149–218. (Kobalava Zh.D., Konradi A.O., Nedogoda S.V. et al. Arterial hypertension in adults. Clinical guidelines 2020. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2020; 25(3): 149–218 (In Russ.)).


https://doi.org/10.15829/1560-4071-2020-3-3786. EDN: TCRBRB.


18. Napoli G., Pergola V., Basile P. et al. Epicardial and pericoronary adipose tissue, coronary inflammation, and acute coronary syndromes. J Clin Med. 2023; 12(23): 7212.


https://doi.org/10.3390/jcm12237212. PMID: 38068263. PMCID: PMC10707039.


19. Bouazizi K., Zarai M., Noufaily A. et al. Associations of aortic stiffness and intra-aortic flow parameters with epicardial adipose tissue in patients with type-2 diabetes. Front Clin Diabetes Healthc. 2023; 4: 1106342.


https://doi.org/10.3389/fcdhc.2023.1106342. PMID: 37304050. PMCID: PMC10250660.


20. Natale F., Tedesco M.A., Mocerino R. et al. Visceral adiposity and arterial stiffness: Echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr. 2009; 10(4): 549–55.


https://doi.org/doi:10.1093/ejechocard/jep002. PMID: 19211568.


21. Мустафина И.А., Ионин В.А., Долганов А.А. с соавт. Роль эпикардиальной жировой ткани в развитии сердечно-сосудистых заболеваний. Российский кардиологический журнал. 2022; 27(S1): 33–39. (Mustafina I.A., Ionin V.A., Dolganov A.A. et al. Role of epicardial adipose tissue in the development of cardiovascular diseases. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2022; 27(S1): 33–39 (In Russ.)).


https://doi.org/doi:10.15829/1560-4071-2022-4872. EDN: PEJLBP.


22. Урясьев О.М., Соловьева А.В., Ческидов А.В. с соавт. Прогностическое значение кардиальных жировых депо у пациентов с ишемической болезнью сердца. Российский медико-биологический вестник им. академика И.П. Павлова. 2023; 31(2): 221–230. (Uryasyev O.M., Solovyeva A.V., Cheskidov A.V. et al. Prognostic significance of cardiac fat deposits in patients with coronary heart disease. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova = I.P. Pavlov Russian Medical Biological Herald. 2023; 31(2): 221–230 (In Russ.)).


https://doi.org/10.17816/pavlovj322796. EDN: WBEUIS.


About the Autors

Mikhail E. Statsenko, MD, Dr. Sci. (Medicine), professor, head of the Department of internal diseases, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshikh Bortzov Sq.
E-mail: mestatsenko@rambler.ru
ORCID: https://orcid.org/0000-0002-3306-0312
Maria V. Derevyanchenko, MD, Dr. Sci. (Medicine), professor of the Department of internal diseases, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshikh Bortzov Sq.
E-mail: derevjanchenko@gmail.com
ORCID: https://orcid.org/0000-0002-6232-4583
Svetlana V. Fabritskaya, MD, PhD (Medicine), associate professor of the Department of internal medicine, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshikh Bortzov Sq.
E-mail: lanabelenkova@mail.ru
ORCID: https://orcid.org/0000-0002-5736-2235
Natalya N. Shilina, MD, PhD (Medicine), associate professor of the Department of internal medicine, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshikh Bortzov Sq.
E-mail: nat.shilina2010@yandex.ru
ORCID: https://orcid.org/0000-0002-1982-6510


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