ПРЕДИКТОРЫ НАЛИЧИЯ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ С СОХРАНЕННОЙ ФРАКЦИЕЙ ВЫБРОСА СРЕДИ АМБУЛАТОРНЫХ БОЛЬНЫХ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ С ОДЫШКОЙ СТАРШЕ 60 ЛЕТ

Background. Dyspnea is the most frequent, but not specific manifestation of the chronic heart failure (CHF). The arterial hypertension (HTN) is one of the causes of CHF. Its verification requires an echocardiography with tissue Doppler, which is not always available in routine practice. Identification of easily estimable CHF predictors in hypertensive patients with dyspnea is an important task. Objective of our study was the identification of the predictors of CHF with preserved ejection fraction (EF) among hypertensive outpatients with dyspnea. Design and methods. We included 116 outpatients with HTN and dyspnea over 60 years old with EF ≥ 50 %. Exclusion criteria were concomitant diseases which might lead to CHF. All patients performed the 6-minute walk test and echocardiography with tissue Doppler. Results . CHF was confirmed in 52,6 % patients. Palpitations, right-sided heaviness below the ribs, swollen feet, as well as reduced tolerance to physical activity were more frequent in older patients with HTN and dyspnea and did not allow to confirm CHF. Patients with confirmed CHF showed higher levels of systolic blood pressure (SBP). They had longer disease anamnesis and lower financial resources. Conclusions. Among elderly hypertensive outpatients with dyspnea every second one has no echocardiographic signs of CHF. SBP ≥ 140 mm Hg according to home measurements is associated with the 6-fold higher probability of CHF with preserved ejection fraction. In the elderly hypertensive outpatients with dyspnea, the duration of HTN more than 20 years and limited financial resources for medications are associated with the increased probability of CHF.