Features of lipid metabolism in chronic heart failure of different genesis with concomitant overweight and obesity

Recently clinical studies demonstrated reciprocal association between traditional cardiovascular risk factors, in particular, hyperlipidemia and obesity, with worse clinical outcomes in CHF. Unlike ischemic heart disease (IHD), where high levels of atherogenic and low of antiatherogenic lipids fraction traditionally associated with worsening of prognosis and course of disease, in conditions of the CHF proven negative impact of the reduction of lipid levels and body mass index. Demonstrated the phenomena called "cholesterol paradox" and "obesity paradox".Aim. To study the features of lipid metabolism in CHF of different genesis with concomitant overweight and obesity.Materials and methods. 240 patients with I–III functional class (FC) of the disease with concomitant overweight and abdominal obesity I–III degree were examined. FC of the disease was established according to the classification of New York Heart Association (NYHA).Normal, overweight and the degree of abdominal obesity was identified by calculating the body mass index. Etiologic factors of CHF were chronic forms of IHD, arterial hypertension, and/or a combination of both. With the help of biochemical blood tests lipid metabolism were assessed.Results. The maximum values as atherogenic and antiatherogenic lipid indicators are investigated in non-ischemic (hypertensive) CHF. Patients with CHF of ischemic genesis are characterized by minimal values of atherogenic fractions of lipids. Patients with combined etiology of CHF occupy the intermediate position of atherogenic fractions content, while they demonstrate the minimum value in the antiatherogenic HDL-cholesterol.Conclusion. Changes of lipid metabolism are varied depending on the etiology of CHF in patients with concomitant overweight and obesity and the most unfavorable in ischemic form of the disease.