СТРУКТУРА КОМОРБИДНОСТИ ПАЦИЕНТОВ С ОСТРОЙ ДЕКОМПЕНСАЦИЕЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ Текст научной статьи по специальности «Медицинские науки и общественное здравоохранение»

СТРУКТУРА КОМОРБИДНОСТИ ПАЦИЕНТОВ С ОСТРОЙ ДЕКОМПЕНСАЦИЕЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ

распространенность коморвидных нозология у пациентов с острой декомпенсацией сердечной

Ключевые слова: хроническая сердечная недостаточность, острая декомпенсация сердечной недостаточности, комор&1дностъ.

Автор, uiuhiliuhihhiJ ж переписку: Окуню И.М, Ц2. Октябрьский, 53/1, г. Кемерово, Российская Федерация, 650Мб, [email protected].

Для цищмшмиг Окунев ИМ. Структура коморбидмости пациентов с острой деюэмпенсецией сердечной недостаточности// Инновационное развитие врача. 2024. №1. С.15-24. dot 1 Q_24412/d-37091 -2024-1 -15-24

Поступила в редакцию: 02.1Z2D23; поступите после доработок 22.01.2024; принята к печати: 14.02Л024

STRUCTURE OF COMORBIDITY IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

Igor M. Okuiav

LA. Kalpinsky Clinicsl Consultative and Diagnostic Center; Oktyebrrsky pjrwpekt, 53/.1, Kemefnvo,.Russian Federation, 650066.

Hghlghti

The review dscusaea the prevalence of comorbidities from various registers, aa wel as geograpNc and ethnic features.

Хроническая болезнь почек

Популяция пациентов с сочетанием ХБП и ХСН

патологией {относительный риск (ОР) 4,7; 95Х доверительный »чтервал (ДИ) 1.4-.1ЗД р .= 0,01 против ОР 1.6; 95« ДИ 1,08 - 3,35; р .= 0,0? лр« индексе коморбидности менее 6) 1131 На поздних стадиях ХБП

смертей на .1 тысячу пациента-лет в популяции 5-Я смерть на 1 тысячу пациенто-лет [141. Хроническая обструкти

2,074; р<0,а05), 1,195 - 2,407, р<0,003> пульмонологом (ОШ 6,151; р<0,00.1) 1231.

Информация об авторе Information about the author

ORC«* 0000-0001-9619-3123

Список литературы

1. Щербишиа ЕВ., Бадин Ю.В., Вайсберг АР. Динамика этиологических причин формирования ХСН а репрезентативной выборка Нижегородской области за в лет наблодения (1888-2007 ш) II Всероссийская конференция ООСН: «Сердечная недостаточность, 2007 год., М, 2007, С. ЗЬ

2. Поляков ДО., Фомин ИВ, Валику лова Ф.Ю, и др. Эгждемиологическая программа ЭПОХА-ХСН: декомпенсация хронической серд№*шй недостаточности в реальной юашической практике (ЭПОХА-Д-ХСН) II Журнал сердечная недостаточность. 2018. Т. .17. № 5, а 299-305. doi: .10.18087/ RHFJ.2016.5.2239

3. Ковалева Ж. Д. Галочюи С. А, Толгачева В. В, и др. Эффекты и клинические исходы ранней инициации сакубитрил/валсартана у пациентов с хронической сердечной недостаточностью с низкой фракцией выброса II Вестник Российского университета дружбы народов. Серия: Медицина. 2020. Т. 24. IP 2. С. .117:434. dot 10^2383/2313-0245-2020-24-2-125-134

4. Яковлев А. А. Особенности диагностики и лечения хронической сердечной недостаточности у лиц старших возрастных грулл // Современные проблемы здравоохранения и медицинской статистики. 2022. N* .1 .С, 259-293. dot 10.24412/23.12-2935-2022-1.-258.-293

5. Amett D.H, Blumenthal R.S4 Albert MA, et aL 20.18 ACC I AHA Guideline on the Primary Prevention ol Cardiovascular Dbeaae: A Report of the American Coiege of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines // Circulation. 20.19. VoL .140, N" .1.1 P. e596-a€46. dol! .10.10.18fljacc2019.03.010 B-lde T, Katcu R, Matsushkna S., el al. Clinical Characteristics and Outcomes of Hospitalized Patients With Heart Failure From the Large-Scale Japanese Registry Of Acute Decompensated Heart Failure (JROADHF) II CllC J, 2021. VoL 85, N»8. P. .1438-1450, dot 10.1253/cirq.CJ -20-0947

7. Hollenberg S.M., Warner Stevenson L, Ahmad T-, et at 2019 ACC Expert Consensus Decision Pathway on Risk Assessment Management, and Clinical Trajectory of Patients Hospitaizad With Heart Failure A Report of the American College of Cardiology Solution Sat Oversight Committee II J Am Coll CerdloL 2Q10.VOL .74, № 15, P. 1M8-2011. doi: 10.101 в/Цаоо2019.(Ш)01 E. СомпЧпо F., Grant PJ, Aboyans.V,etaL 2018 ESC

Guldefcres on diabetes, pre-dlebetes, and cardiovascular diseases developed in collaboration with the EASD // Eur Heart J. 2020. VOL .4.1, №2. P. 255-323. dot 10.1083/ e«hBartJ/ehz486

9. Lawson OA, Zaccardl F., Squire L, et .aL 20.-.year trends in cause-specific heart failure outcomes hy sex, socioeconomic status, and place of dlajyrosls: a population-based study И Lancet Public Health, 2019, Vol. 4, № 8. P. е40в-е420. doi: 10.1018/ S2488-2687(19)30108-2

.10. Koh A.S., Tay ЖТЧ Teng TJ-LK, et aL A comprehensive

population-based characterization of heart Mure with mid-range ejection fraction // Eur J Heart FaiL 20.17. VoL 19, №12. P. 1624-1834. dot 10.1002/ajhf.945 I t .Tromp O, Ouwerkerk Ж, van Veldhulsen D. J., et al. A Systematic Review and Network Meta-Analysis of Pharmacological Treatment of Heart Failure With Reduced Ejection Fraction II JAC.C Heart Fal. 2022. VoL 10, № .4. P. 285-286. Hot .1.ai0ie/l4cht2021.08.0.0.4

12. Арутюнов А.Г., Драгунов Д.0Ч Арутюнов FJL, и др. Первое открытое исследование синдрома острой декомпенсации сердечной недостаточности и сопутствующих звбопеваний в Российской Федерации. Независимый регистр ОРАКУЛ-РФ // Кардиология. 2015. Т. 55, N" 5. С. 12-21

13. Schaubroack НА, Oevaert S., Bagshaw SAL, at aL Acute cardloranal syndrome In acute heart Mure; focus on renal replacement therafq> II Eur Heart J Acuta Cardlovaec Cara. 2020. VoL .9, N».7. P. 802-811. dot 10.1177/2048872620933371

14. Anlgo M, Jessup M., Mullens W, et aL Acute heart failure // Nat Rev Dis Primers. 2020. VoL 8, N« 1 .P. 18. dot .10.1038/84.1572-020.-015.1.-7

.15. Chloncel .0, Mebazaa A.. MagglonI A. P. at aL Acute heart Mure congestion and perfusion status-Impact of the clinical classification on in-hospital and long-term outcomes; Insights from the ESC-EORP-HFA Heart Failure Lonfl-Term Registry // Eur J Heart FalL 2019. VoL 21, W It P. 1338-1352. doi 10.1002/ejhf.1.492 1B. Masip A, Frank Peacok W, Arrigo M-, at aL Acuta Heart Failure Study Group of tha Association for Acute Cardiovascular Care (ACVC) of the European Society of Cardiology- Acute Heart Failure in the 2021 ESC Heart Failure Guidelines: a scientific statement from the Asaor

ciation for Acute Cardiovascular Care (ACVC) of the European Society of Cardiology // Eur Heart J Acute Cardlovasc Care. 2022, VOL 11, № 2. P. 173-185 dot Iai093/ehjacc/zuab122

17. Farmakls О, Parfasb J., Fllippatos G. Acute heart failure: treatment The ESC Textbook

of Cardiovascular Medicine. Oxford: Oxford .University Press, 2018. dot .10.1 D93/med/9780.1987.84908.003.0441

18. McCallum W.. Tlghiouart H, Tastanl J. M,. et aL Acute Kidney Flection Declines In the Context of Decongestlon In Acute Decompensated Heart Failure // JACC Heart Failure. 2020. Vol. a, N» .7. P. 537-547. dot 10.1И6/ ]Jcht2020.03.000

1a Kocabaj O, Klvrak Т., Yilmaz fetekln G. M, et aL Adherence to guideline-directed medical and device Therapy In outpAtlenta with heart failure with reduced ejection fraction: The ATA study /I Anatol J Cardiol 202a VOL 24, H> I P. 32-4Q- dot 1114744/ AratoUCardk)L2020.91771

20. Buda V., Prallpcean A., Cozma D4 etaL An Up-.to-Date Article Regarding Particularities of Drug Treatment In Patients with Chronic Heart Failure Ц J .Clin Med. 2022. VOL .11, W 7, P. 20-22. dot .10«339.0/Jcm11072020 21 Окунав ИМ, Кочасгина АЖ, Каштвлаг ВЯ. Хроническая и острая декомпенсиронанная сердечная недостаточность: актуальные вопросы II Комплексные проблемы сердечно-сосудистых ааболеваний. 2022. Т. 11. W 2. С. 184-195.

22. Anand L How I treat anemia In heart failure // Blood. 2020. Vol .136, М» 7. P. 790-800. dot 10.1182/ bio CKL2019004004

23. Calle Rublo M., Rodriguez Hermosa JJ-, Mlravltlles M, et aL Determinants in the Underdiajrosis of COPD In Spaln-CON О СЕРО С Study. // J Clin Mad. 2022 VoL .1.1, N» 9. P. 2670. dot 10.3390/lcmll 092670

24. Solomon S. U, McMurray J. J. V, Anand L S4et aL Anglotensln-neprllysfri IrWbition in heart failure with preserved Section fraction // N Engl J Med. 2019. VoL 38.1, №17. РЛ609-1В20. dot 10.1058/NEJMoal908655

25. Odajlma S, FuJImoto W, Kiaoda CL, at at Association of congestion with worsening renal function ki acute decompensated heart failure according to age // ESC Heart FalL 2022 VOL 9, N" 8. P. .4250-4261 dot 10.1002/ ehf2.14!57

2a Дед on KR, Шестакояа MB, Гапстян ГА Распространенность сахарного диабета 2 типа у взрослого насепешя России (исследование NATION) II Сахарный диабех 2010. Т. 19. №2. С. 104-112.

27. Body mass index and prognosis in patients with chronic heart failure: 50 European Journal of Preventive [Ethernet] IS. Kancheleh, S. J. Росой«, a Wans fa др.] II Cardiology. - VoL 27, № 2. - URL: httpsjl acadamlc.oup.com/aur5pc/artlcle/27/2_suppl/46/ei25514 (accessed: 2b0.3.2023), dot 10.1181/ C1RCU LAT10 NAH A.10йв79779

28. Козиолона НА., Векпич А.С. Факторы рисха и диагностическое значение N-тарминального фрагмен-

та мозгового натрийуретаческого пептида как маркера острой декомпенсации сердечной недостаточности при диабетической болезни почек II Роеочйасий кардиологический журнал. 2021 Т. 28. № 3. ft 87-74. dot 10-15829/1560-4071 -2021 -4337 29. Chloncal О, LalnscaK М, Seferovlc P. М, at aL Epidemiology and one-year outcomes In patients with chronic heart failure and preserved, mid-range and reduced Section fraction: an analysis of the ESC Heart Failure Long-Term Registry // Eur J Heart Рай. 2017. VoL

19, да 12. P. 1574-1585. dot ЮДСОЭДЫШ за Abld L, Charfeddlre S, Kammoun 1 et aL Epidemiology of heart failure and long-term follow-up outcomes In a north-African population: Results from the NAtlonal Tunisian RFgistry of Heart Failure (NATURE-HP) II PLoS ONE 2021 VoLIB, №5. P. a0251858. dot .111371/ JoumaLpone.0251858

3.1 Tong M, Salto Т., Zhal P„ et aL Mltophagy Is Essential for Maintaining Cardiac Function During High Fat Diet-Induced Diabetic Cardiomyopathy // Ore Res. 2019. VoL .124, N*9. P. 1380-1371 dot 10,1161/ CI RC R ESAHA.118J14807

32. Antza O, Kostopoulos G., Mostafa S., et aL The links between Bleep duration, obesity and type 2 diabetes mellltus II J EndocrlnoL 2021 VoL 252, W 2 P. 125rl4,l dot iai530/40E-21.-0155

33. O'Connor С M, МШег А. В, Blair J. E, et aL Causes of death and rehospltallzatlon to patients hospitalized with worsening heart faflire and reduced left .ventricular ejection fraction: results from Efficacy of Vasopressii Antagonism In Heart Failure Outcome Study with Toivaptan (EVEREST) program II Am Heart J. 201.0. VoL 158, №5 P. 841-649. dot 1й10164^1^-01002.053

34. Gmblc Rotkvk P., Planlnlc Z, Llberati Prao A. M, et aL The Mystery of Dlebetlc Cardiomyopathy: From Early Concepts and Underlying Mechanisms to Novel Therapeutic Possibilities // Int J Mol ScL 2021 VOL 22, №11 P. 5973. dot 10.3390/ЦГП&22115973

35. DamanlK J, Yur* E. Type 2 Dlebetes Mellltus and Cognitive Impalrmwit II Acta Med Indones. 2021 VOL S3»

да2.р.21Эг-22а

за OMeara E, Clayton Т., McEntegart M, et aL CUnlcel correlates and consequences of anemia In a broad spectrum of patients with heart faUure: results of the Candesartan In Heart Failure: Assessment of Reduction ki Mortality and Morbidity (CHARM) Program // .Circulation. 2006. VOL 113, N»7. P. 986-994, dot 10,1161/ C1RCULAT10NAHA.105J82577

37. DeFHippis E. M, Van Spall H 6. C. in acute HF and Iron deficiency, IV ferric carboxymattose reduced HF hospltalzatlons, but not CV death, at .1 у. U Ann Intern Med. 2021 VoL 174, № 4. P. 45. «№10.7328/ ACPJ202104200-045

38. Mozaffarlan D., Nye R., Levy W. C. Anemia predicts mortality In severe heart failure: the prospective randomized amlodlpine sirvival evaluation (PRAISE) II J Am Coll CardloL 2003. VOL 41 N"11 P. 1033-1939. dot 10.1016/s0735-1097(03)00425-X

39. Gnaerweld H Januzzf JL L, Dämmen K et aL Anemia and Mortality In Heart Failure Patients A Systematic Review and Meta-Analysis // J Am Coll Cardiol. 2008. Vol. 52, NHO. P. 818-827. riot .10.101« HactL200a.04.0B1

4a Ststanla p., Angela a S_, Janess C. Hole of comortjldtUas In heart Mure prognosis: Part Ü Anaemle, Iron deficiency, diabetes, atrial fibrillation // Eur j Piev CardloL 2020. VOL 27, № 2. P. 27-34. dot 10.1177/2047487320960288

41 Docharty IC F., Welsh P„ Verma S„ at aL Iron Deficiency In Heart Failure and Effect of Dapagliflozln: Findings From DAPA-HF // CtrculatlorL 2022. VOL .1.48, N* ,13. P. 980-994, dot 10,1181/ C1RCLI LAT10 NAH A.122.060511

42. Di Tano G., Navazio A. Lo studio AFF1RM-AHF; risultatl, Impatto del COV1D-19 a ln^Ucazlonl cllnlcha m* AFFIRM-AHF trial: results, knpact of GCMD-.19 and clinical implications]. G Hal Cardiol (Rome). 2021 VOL 22, N* X P. 19M96. dot 10.1714/3557.35337 41 Mu^ial M. S, Ghanl A. R, Kum» S, at aL Haart Failure Patients and Implications of Obesity; A Single Center Retrospective Study // Cureus. 2021 VOL .13, № 0. P. .181.40. dot 10.7759/cureuaiai40

44. Donataccio M P., Vanzo A^ Bosello Donatacclo .0. Obesity paradox and heart failure // Eat Weight Disord. 2021 VOL 28, N* B. P. 1897-1707. dot 10,1007/ S40519-020-00982-9

45. Коков AJ-L, Масенко ВЛ, Карееве АЛ, и др. Портрет пациента со стабш&ной ишамической болезнью сердца и нарушением мышечного статуса. // Кэрдиснасгупярная терапия и г^офилактика. 2022. Т. 21 № .12. С. .18-23. dot .10.15829Л728-8800.-2022-345.4

46. Торопцова RB., Фекпистов AJO. Патология коетно-мьшечной системы: фокус на сарколанмю и остеосаркопению // Медицинский совет. 2019. »АС, 78-88.

47. Kenchalah S., Росос* S. J, Wang D^ at aL Body mass Index and prognosis h patients with chronic heart Mure; Insights from the Candesartan In Heart Mure: Assessment of Reduction In Mortality and morbidity (CHARM) program. Circulation. 2007. .VoLII.8, №8. P. 827r 638. dot 10.1181/C1RCULATK1N AHA.108Л79779

4a Сафиупшиа AA, Усквч ТЛС, Сайпудинова KM, и др. Сердечная недостаточность и ожирание // Терапевтический архив. 2022. Т. 94. N»9. С. 1115-1121 dot 1 а28442/00403660.2022.09^01837

References

1 Shchefblnlna EV, Badln YuV, Welsberg AR. Dynamics of the etiological causes of OIF in a representative sample of the Nlzhny Novgorod region over 9 years of observation (1998-2007). All Russian Conference of CHB •Heart failure, 2007». VL, 2007. P. 38 tin RussJ.

2. PolyaKov DS, Fomln IV, VaUKubjva PYu, et a! The EPOCH-CHF epklemiologlcBl program: decompwwated chronic heart Mure in real-life clWcd practice (EPOCH-D-CHF). Journal of Heart Fallura. 2016; 17(5): 299-305 tin RusaJ. dot .10.18087/RHFJ.2016.5.2239

3. Kobalava ZD, Galochldn SA, TolKacheva W, at aL Effects and clinical outcomes of aarly initiation of sacubttrli/valsartan In patients wtth chronic heart Mure with a low election fraction. RUDN Journal of Medicine. 2020; 24(2); 125H34 (in RussJ. dot 10JZ23B3/23l3.-.0245.-2020.-24.-2-.125-13.4

4. Yakovlev AA. Features of dlagnods and treatment of chronic heart Miae In older age groins. Cujranf problems ol health cam and medical statistics. 2022; .1; 259-293 tin RusaJ. dot .10.24412/23.12-2935-2022-.1.-259-293

5. Amett DK, Blumenthal RS, Albert MA, et aL 20.18 AC.C / AHA Guideline on the Primary .Prevention of Cardiovascular Disease: A Report of the American .College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. CireuJaiion. 20.19; 14001); B596-B646. dotlQ.1Die/)4acc£0.19.03.010

a. Ids T, Kaku H Matsuahfena S, et aL Clinical Characteristics and Outcomes of Hospitalized Patients With Heart Failure From the Large-scale Japanese Registry Of Acute Decompensated Heart Failure

Cite J. 2021; 85(9); 1438-1450. dot 10.1253/ Cirq.CJ-20-0947

7. Hollenberg SM Warner Stevenson L, Ahmad T, at aL 2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical .Trajectory of Patients Hospitalized wtth Heart Failure: A Report of the American College of Cardiology Decision Set Oversight

Committee. J Am Co« CanJM. 2018; .74.(15)? .19.66-20.1.1 dot 10.1016/yacc.20ig.oaooi

8. Cosentlno F, Grant PJ, Aboyans V, et aL 20.19 ESC Guidelines on diabetes, pre-dlabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020; .4.1(2): 255-321 dot .1.0.1093/aurhearlJ/ ehz4S6

9. Lawson CA, Zaccardl F, Squire I, et aL 20-year trends In causa-apacific heart Mure outcomas by sex, socioeconomic status, and place of diagnosis: a population-based study. Lancet Public Health. 20.18; 4(6): 8406-6420. dot .10.10.16/S2468-2667t19)30.108.-2

.10. Koh AS, Tay W, Tang THK, at aL A comprehensive population-based characterization of hear t Mtaa with mid-range ejection fraction. Eur J Heart Fan. 2017; 19(12); 1624-1634. dot 10.1002/ejht945

11 Thjmp J, Ouwerkerk W, van Veklhulsen DJ, et aL A Systematic Review and Network Meta-Analysls of Pharmacological Treatment of Heart Faiure .WIth Reduced Ejection Fraction. JACC Heart Faft 2022; .1.0.(4); 295-296. dot 10.1016/J.Jcht2021.09.004

12 Arutyunov AG, Dragunov DO, Amtynrcv GP, at aL First open study of syndrome of acuta decompensation of

13. Schaubroack HA, Oevaert S, Bagshaw SM, at aL Acuta

14. Arrigo M, Jassup M, Mullens W, at aL Acuta heart failure. Nat Rev Di, Primers. 2020; ß<1); .1ft riot .10.1038/ B41S72-020-0.151.-7 .15. Chloncel Q, M

le ESC-EORP-HEA Heart Failure Long-Term Registry. Eur J Haart Fat 20.19; 21.(1.11: .1338.1352. dot10.1002/ejhf.1492

ulp 4, Frank Peacok W, Arrigo M, et A Acute Heart i Study Group of the Association for Acute ir Care (ACVC) of the European Society of te Heart Faiure In the 2021. ESC Heart

¡r Care (ACVC) of the n Society Of Cardiology. Eur Heart J Acute C Care. 2022; 11i2); 173H85 dot 111093/

18, McCallum W, Tl^üouart H, U

In Acuta Decompensated Heart Fallura. JACC Haart 2020; 8(7): 537-547. dot 10.1016/

Mvnk T, Yilmaz fetekln GM, et eL

25. Odajlma S, Promote W, Kuroda K, et aL Association of congestion with worsening renal firtcflon In acute decompensated haart failure according to age. ESC Heart Fatt 2022; 9(6): 4250-4281. dot .10.1002/ehf2.14l57

ra MV, Galstyan GR. Prevalence of s In the adult population of Russia .....s. 2016; 18(2); 104-112

3a Abld L, Charfeddine S, Kammoun I, et aL Epidemiology of heart Muse and long-term 1ollow-up outcomes In a north-African population: Results from the NAtlonal Tunisian REglstry of Heart Failure (NATURE-HF). PLoS ONE 2021; 16(5); 0251658. dot .111371/

to T, Zhal P, at aL Mltophagy Is Essential Cardiac Function During High Fat Dlet-Inducad Diabetic Cardiomyopathy. Ore Res. 2019; 12419)."1380-1371. dot .1D.1161/C1RCRESAHA.118.314807 32. Antza C, Kostopoulos 0, Mostafa S, at aL The links

24, Solomon SD, McMurray JJV, Anend IS, et aL Angiotensin-neprllysfri IrWbition in heart failure with preserved ejection fraction. N Engf J Mad. 2019; 381(17); .1609.-1621 dot 10.1056/NEJ Moa1908655

35. Damanlk J, Yunir EType 2 Diabetes Mellltus and Cognitive ImpalrmenL Acta Mad Indonesia. 2021;53(2): 213-220.

36. O'Meara E, Clayton T, McEntagart MB, et aL Clinical correlates and consequences of anemia In a broad spectrum of patients with heart failure: results of the

Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program. Cteutatfan. 2006; 113(7}: 986-994. dot 10.1181/ C1RCULAT10NAHA.10S.582577

37. DeFiUppis EM, Van Spall HGC. In acute HF and Iron deficiency, IV ferric carboxy maltose reduced HF hospitalizations, but not CV death, at .1 y, Ann totem Med, 2021; 174(4.): 45. dot10.7328/ACPJ202104200-04S

38. Mozaffarian D, Nye R, Levy WC. Anemia predicts mortality In severe heart laiure: the prospective randomized amlodlplne survival evaluation (PRA1SS. J Am Co« Cardtot 2003; 41.(11): 1933-1939. dot 10.1010/ s0735-1097(03)00425-x

39. Groanvald HF, Januzzl JL, Damman K, et aL Anemia and Mortality to Heart FaHiae Patients A Systemetlc Review and Meta-Analysls. J Am CoV CerrftoJ. 2008; 52(10): 818-827. dol: iai016/J4acc20Qa.04-061

40. Stafanla p, Angela BS, Jeness S. Role of comorbidities In heart failure prognosis: Part l: Anaemia, Iron deficiency, diabetes, atrial fibrillation. Eur J Pre* Cardtol 2020; 27(2); 27-34. dot 10.1177/2047487320960288

41 Docharty KF, Welsh P, Verma S, at aL Iron Deficiency In Heart Failure and Effect of DapaglHIozin: Findings From □APA-HF. Circulation. 2022; .148(13): 980-994. dot 10.1161/aRCULATlONAHA.122.080511 42. DI Tano G, Navazlo A. Lo studio AFFIRM-AHF; rtsultati, lmpatto dal COV1D.-19 a ln^llcazlonl cllnlche [The AFFLRM-AHF triat results, Impact of COV1D.-18 and rilnka 1 Impllca-

fernO. a «al Cardtoi (Rome). 2021; 22(3): 193-18«. dot .10.1714/3557.35337

43. Mughal MS, Ghanl AR, Kumar S, at aL Heart Failure Patients and Implications of Obesity: A Single Canter Retrospective Study. Cureus. 2021; .13(9); 18140. dot 1 [17759/cureus.l 8140

.4.4. Donatacclo MP, Vanzo A, Bosallo Donatacdo .0. Obesity paradox and heart failure. Eaf WWgfit Disord, 2021; 26(6): .1887-1707. dot .10.1007/ S40519-020-00982-9

45. Kokov AN, Masenko VL, Kereava Al, at aL Portrait ol a patient with stable coronary heart disease and Impaired muscle status. Cardiovascular therapy and prevention, 2022; 21(12); 16-23 (In RussJ. dot .10.15829/1728.-8800-2022-3.454

46. Toroptsova NV, Fekllstov AYu, Pathology of the musculoskeletal system: focus on sarcopenla and osteosarcopenla. Medical Council. 20.19; .4; 78-86 (In

47. SclomarS, Moscuccl F, Salvlonl E, et aL Rola of gender, age and HMI to prognosis of heart failure. Fur J Prey Cardtot 2020; 27(2); 46-51 dot .10.1177/2047.487320981980

,4a SafliMna AA, Uskach TM Saypudlnova KM, at aL Heart fafcre and obesity. Terapevtfchesfcff Arichlv O'er. Arktll. 2022; 94(9); 1115-4121 An RUSBj. dot 10.26442/00403860.2022.09.201837