THE EFFECT OF VISCERAL OBESITY ON THE CONDITION OF THE MAIN ARTERIES IN PATIENTS WITH CHRONIC HEART FAILURE
Aim: to study the relationship between the severity of visceral obesity and the condition of the main arteries in patients with chronic heart failure (CHF) with obesity. Materials and methods. 116 patients with CHF of stage I -IIA of functional class I -III (FC) aged 40 to 65 years were included. All patients were divided into 3 comparable groups: group 1 included patients with CHF with normal body weight (n = 34), group 2 - overweight CHF (n = 40), group 3 - CHF and 1 - 2 degree obesity (n = 42). There were no differences in severity, CHF FC and NT-proBNP levels between the study groups. A clinical examination was performed, indicators of visceral obesity and adipokine status were evaluated. Arterial stiffness was assessed by measuring the pulse wave propagation velocity (CWPV) through the vessels of muscular (CWPVm) and elastic (CWPVe) types. Results. A high percentage of visceral obesity was found: 17.6 % among people with normal BMI, 70 % among overweight people and 100 % among obese people. A statistically significant increase in CWPVe was found in patients with CHF and obesity in comparison with patients with CHF and normal body weight (10,5 [8,9; 11,6] vs 8,5 [7,5; 8,4] m/s). CWPVe > 10 m/s was significantly more common among overweight or obese patients compared to patients with normal body weight (62,4 and 83,2 % vs 37,5 %, respectively). There was a significant decrease in the concentration of adiponectin and an increase in the level of leptin from group 1 to group 3. The correlation analysis showed the presence of reliable relationships between the parameters characterizing the elasticity of the vascular wall and the severity of visceral obesity, as well as laboratory markers of obesity. Conclusion. The data obtained indicate a negative effect of visceral obesity, hyperleptinemia and hypoadiponectinemia on the condition of the main arteries in patients with CHF.