Comorbidities and sex differences in chronic heart failure of ischemic etiology

Abstract Background: Comorbidities and sex differences play a major role in chronic heart failure (CHF). However, it is unknown whether the prevalence of comorbidities differs between heart failure with preserved ejection fraction, mildly reduced ejection fraction, and reduced ejection fraction in men and women. Methods: We examined 216 patients with chronic heart failure, whose main etiological factor was ischemic heart disease. We studied gender differences and the prevalence of cardiac and extracardiac comorbidities based on the left ventricular ejection fraction. Results: Chronic heart failure of ischemic etiology was significantly more common in men than in women, with a prevalence of 68.1% and 31.9%, respectively. Moreover, women were older than men at the time of hospitalization. Arterial hypertension was significantly more frequent among patients with heart failure with preserved ejection fraction, with a prevalence of 92% (p<0.05). Men are more predisposed to heart failure with reduced ejection fraction, while women predominate in heart failure with preserved ejection fraction. Extracardiac comorbidities among patients with heart failure with reduced ejection fraction were represented by chronic obstructive pulmonary disease (13.1%), congestive pneumonia (6.6%), and a history of stroke or transient ischemic attack (11.5%). Patients with heart failure with mildly reduced ejection fraction were more likely to have nonalcoholic fatty liver disease (51.9%), as well as renal and thyroid dysfunction (27.1% and 24.3%, respectively), compared to patients with preserved ejection fraction. Conclusions: The results obtained from this study confirm and supplement the existing data regarding the prevalence of chronic heart failure, gender differences, and the impact of comorbidities on the clinical status and prognosis of patients with chronic heart failure.