Sažetak | Cilj istraživanja: Ispitati povezanost bubrežne funkcije, KKS-a, ritma rada srca, markera srčane ishemije, upale i markera srčanog zatajivanja kod bolesnika sa sniženom ejekcijskom frakcijom lijeve klijetke i potrebom rehospitalizacije. Nacrt studije: Presječna studija s povijesnim podatcima. Ispitanici i metode: U studiju je uključeno 50 odraslih bolesnika, oba spola, medijana dobi 76 godina, s dijagnozom srčanog zatajivanja sa sniženom ejekcijskom frakcijom LK. Podatci su prikupljeni iz medicinske dokumentacije. Bilježeni su dob, spol, elektroliti (natrij i kalij), bubrežna funkcija (urea, kreatinin), KKS (eritrociti, hemoglobin, hematokrit, MCV), ferogram (Fe, TIBC, UIBC, feritin, transferin), CRP, EKG (ritam rada srca, fibrilacija atrija), troponin I, NTproBNP te ehokardiografski parametri: EF LK, dijametar LK u dijastoli i sistoli, dijastolička funkcija i dimenzije lijevog atrija. Za statističku analizu korišten je statistički program MedCalc Statistical Software version 19.1.7 (MedCalc Software Ltd, Ostend, Belgium; https://www.medcalc.org; 2020). Rezultati: Najučestaliji komorbiditeti uključuju hipertenziju, šećernu bolest, koronarnu bolest srca i KOPB. Upala pluća značajno je češća kod bolesnika hospitaliziranih prvi put (P = 0,03), dok je frekvencija srca značajno niža kod rehospitaliziranih bolesnika (94 medijan, P = 0,04). Značajno su veće vrijednosti dijametra LK tijekom sistole kod rehospitaliziranih bolesnika (51 medijan, P = 0,003), kao i dijastolička disfunkcija (P = 0,04). Bolesnici hospitalizirani prvi put imaju značajno veće vrijednosti EF lijeve klijetke (P = 0,03). Ostali parametri nisu se pokazali značajnima prema broju hospitalizacija. Zaključak: Istraživanjem je utvrđeno da rehospitalizirani bolesnici imaju veće oštećenje sistoličke i dijastoličke funkcije srca od bolesnika hospitaliziranih prvi put. |
Sažetak (engleski) | Objective: The aim of the study was to examine the correlation between renal function, CBC, heart rhythm, markers of cardiac ischemia, inflammation and markers of heart failure in patients with reduced left ventricular ejection fraction, and the need for repeated hospitalization. Study design: Cross-sectional study with historical data. Participants and Methods: The study included 50 adult patients of both genders, median age 76 years old, with a diagnosis of heart failure with reduced left ventricular ejection fraction. The data was collected from the patients’ medical records. Age, sex, electrolytes (sodium and potassium), renal function (urea, creatinine), CBC (erythrocytes, hemoglobin, hematocrit, MCV), ferrography (Fe, TIBC, UIBC, ferritin, transferrin), CRP, ECG (heart rhythm, atrial fibrillation), troponin I, NTproBNP and echocardiographic parameters including left ventricular EF, left ventricular diameter in diastole and systole, diastolic function, and left atrial dimensions were observed. The statistical program MedCalc Statistical Software version 19.1.7 (MedCalc Software Ltd, Ostend, Belgium; https://www.medcalc.org; 2020) was used in the statistical analysis. Results: The most common comorbidities are hypertension, diabetes mellitus, coronary heart disease and COPD. Pneumonia was more common in patients hospitalized for the first time (P = 0.03), while heart rate was lower in patients with repeated hospitalizations (94 median, P = 0.04). There were significantly higher values of left ventricular diameter during systole in patients with repeated hospitalizations (51 median, P = 0.003), as well as diastolic dysfunction (P = 0.04). Patients hospitalized for the first time recorded higher left ventricular EF values (P = 0.03). Other parameters did not indicate significant value in relation to the number of hospitalizations. Conclusion: The study found that patients with repeated hospitalizations had greater impairment of systolic and diastolic heart function than patients hospitalized for the first time. |