scholarly journals Does physical training increase insulin sensitivity in chronic heart failure patients?

2004 ◽  
Vol 106 (5) ◽  
pp. 459-466 ◽  
Author(s):  
L. W. E. SABELIS ◽  
P. J. SENDEN ◽  
B. C. M. TE BOEKHORST ◽  
H. J. HULZEBOS ◽  
A. VAN DE WIEL ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Sensitivity ◽  
Chronic Heart Failure ◽  
Physical Training ◽  
Heart Association ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Peak Vo2

To determine the effect of training on insulin sensitivity (IS) and how this relates to peak VO2 (peak oxygen uptake) in CHF (chronic heart failure), 77 CHF patients (New York Heart Association class, II/III; men/women, 59/18; age, 60±9 years; body mass index, 26.7±3.9 kg/m2; left ventricular ejection fraction, 26.9±8.1%; expressed as means±S.D.) participated in the study. Patients were randomly assigned to a training or control group (TrG or CG respectively). Sixty-one patients completed the study. Patients participated in training (combined strength and endurance exercises) four times per week, two times supervised and two times at home. Before and after intervention, anthropometry, IS (euglycaemic hyperinsulinaemic clamp) and peak VO2 (incremental cycle ergometry) were assessed. Intervention did not affect IS significantly, even though IS increased by 20% in TrG and 11% in CG (not significant). Peak VO2 increased as a result of training (6% increase in TrG; 2% decrease in CG; P<0.05). In both groups (TrG and CG), the change in IS correlated positively with the change in peak VO2 (r=0.30, P<0.05). Training resulted in an increase in peak VO2, but not in IS. Whether physical training actually increases IS in CHF patients remains unclear.

Abstract 3791: Improved Ventricular-Arterial Coupling After 4 Weeks of Exercise Training in Patients with Chronic Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marcus Sandri ◽  
Stephan Gielen ◽  
Norman Mangner ◽  
Volker Adams ◽  
Sandra Erbs ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Endothelial Function ◽  
Training Group ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Lv Function ◽  
Ventricular Ejection Fraction

Background: The concept of ventricular-arterial coupling implies that LV-function is determined by the three factors left ventricular diastolic, left ventricular systolic and arterial elastance. We have previously documented an improvement in endothelial function and systolic LV-function in patients with chronic heart failure (CHF) after 6 months of exercise training (ET). It remains, however, unclear, how shorter ET periods may affect endothelial, systolic and diastolic ventricular function as echocardiographic parameters related to ventricular arterial coupling in patients with CHF. METHODS: In this ongoing study we randomised 43 patients with stable CHF (age 60.3 ± 2.9 years, EF 27.4 ± 1.7%, VO 2 max 14.7 ± 4.3ml/kg*min) to a training or a control group (C). Patients in the training group exercised 4 times daily at 70% of the individual heart rate reserve for 4 weeks under supervision. At baseline and after 4 weeks the E/A ratio and septal/lateral E’/A’ velocities were determined by echocardiography with tissue Doppler. Exercise capacity was measured by ergospirometry and flow-mediated dilatation (FMD) was assessed by high-resolution radial ultrasound. RESULTS: After only 4 weeks of ET oxygen uptake at peak exercise increased from 14.9 ± 3.3 to 18.1 ± 4.7 ml/min/kg, (p<0.01 vs. C) in training subjects. Left ventricular ejection fraction improved from 26.8 ± 4.6 to 33.1 ± 5.5% (p<0.05 vs. C) in patients of the training group while it remained unchanged in the control group. E/A-ratio mended from 0.63 ± 0.12 to 0.81 ± 0.22 (p<0.01 vs. C) in training patients. Septal E’ velocities increased from 5.5 ± 0.5 to 7.8 ± 1.4 cm/s in training patients (p<0.05 vs. C). FMD of the radial artery improved from 8.2 ± 2.1 to 15.2 ± 3.8% (p<0.01 vs. C) as a result of ET. CONCLUSIONS: Only 4 weeks of endurance training are highly effective with significantly improved FMD accompanied by an emended systolic and diastolic LV-function. We hypothesise that the improvement in LV-EF in training patients may be caused by a corrected ventricular-arterial coupling: ventricular diastolic relaxation and effective endothelial function are ameliorated resulting in an augmentation of stroke volume.

scholarly journals Prognostic algorithms for the progression of chronic heart failure depending on the clinical phenotype

2019 ◽  
Vol 18 (3) ◽  
pp. 41-47
Author(s):  
E. A. Polunina ◽  
L. P. Voronina ◽  
E. A. Popov ◽  
I. S. Belyakova ◽  
O. S. Polunina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Chronic Heart Failure ◽  
Clinical Phenotype ◽  
Left Ventricular ◽  
Regression Method ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Logistic Regression Method

Aim. To develop a mathematical equation (algorithm) to predict the development of chronic heart failure (CHF) for three years, depending on the clinical phenotype.Material and methods. Three hundred forty five patients with CHF with a different left ventricular ejection fraction (preserved, mean, low) were examined. The control group included somatically healthy individuals (n=60). In all patients, 48 parameters that most widely characterize the pathogenesis of CHF (gender-anamnestic, clinical, instrumental, biochemical) were analyzed. To isolate phenotypes, dispersive and cluster analysis was used: the hierarchical classification method and the k-means method. In the development of algorithms we used binary logistic regression method. We used ROC curve to assess the quality of the obtained algorithms.Results. We identified four phenotypes in patients with CHF: fibro-rigid, fibro-inflammatory, inflammatory-destructive, dilated-maladaptive. For the first three phenotypes, a mathematical logistic regression method was used to develop mathematical models for predicting the progression of CHF for three years, with the release of predictors for each phenotype. Belonging to the dilatedmaladaptive phenotype according to the results of the analysis is already an indicator of an unfavorable prognosis in patients with CHF.Conclusion. The developed algorithms based on the selected phenotypes have high diagnostic sensitivity and specificity and can be recommended for use in clinical practice.

scholarly journals CORRELATION BETWEEN VAS OPRESSIN CONCENTRATION AND CHRONIC HEART FAILURE SEVE RITY: CHARAC TERISTICS OF PA TIENTS WITH TERMINAL AND DECOMPE NSA TED HEART FAILURE

The Clinician ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 36-42
Author(s):  
E. S. Trofimov ◽  
A. S. Poskrebysheva ◽  
N. А. Shostak
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Symptoms ◽  
Left Ventricular ◽  
Stage Iii ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Significant Difference ◽  
Functional Classes

Objective: to evaluate vasopressin (VP) concentration in patients with varying severity of chronic heart failure (CHF), intensity of clinical symptoms, and decreased level of left ventricular ejection fraction (LVEF). Materials and methods. In total, 120 patients (44 males, 76 females) with CHF of varying genesis (mean age 72.12 ± 10.18 years) and 30 clinically healthy individuals (18 males, 12 females) as a control group (mean age 33.4 ± 6.23 years) were examined. All patients underwent comprehensive clinical and instrumental examination in accordance with the standards for patients with CHF. The VP level was determined using ELISA. Statistical analysis was performed using the IBM SPSS Statistics v. 23 software.Results. The patients with CHF had significantly higher blood VP levels compared to the control group (72.91 ± 53.9 pg/ml versus 6.6 ± 3.2 pg/ml respectively; p <0.01). At the same time, patients with stage III CHF had significantly lower VP levels than patients with stages IIВ and IIА (35.61 ± 21.53 pg/ml versus 71.67 ± 48.31 pg/ml and 86.73 ± 59.78 pg/ml respectively; p<0.01). A similar picture was observed for the functional classes (FC). For instance, for CHF FC II and III, the VP level was 91.93 ± 67.13 pg/ml and 77.95 ± 54.01 pg/ml respectively, while for FC IV it decreased to 50.49 ± 28.18 pg/ml (p <0.01). The VP concentration in patients who subsequently perished was significantly lower than in patients who survived (48.79 ± 26.30 pg/ml versus 79.72 ± 57.73 pg/ml; p = 0.012). Moreover, in patients with LVEF <50 %, the VP level was significantly lower than in patients with LVEF >50 % (59.43 ± 42.51 pg/ml versus 86.43 ± 62.46 pg/ml respectively; p <0.05).Conclusion. The observed significant differences in VP in patients with stage III and IV CFH can indicate depletion of neurohumoral mediators in this patient category. However, a correlation between the VP level and the level of LVEF decrease can indicate a significant difference in the role of VP in CHF pathogenesis in patients with preserved and decreased LVEF. This observation requires further research.

P6323Exercise capacity as predictor for anaemia or iron deficiency in patients with chronic heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Ebner ◽  
G Dinopoulos ◽  
R Evertz ◽  
T Garfias Macedo ◽  
B Godoy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Iron Deficiency ◽  
Exercise Capacity ◽  
Left Ventricular ◽  
World Health ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Peak Vo2 ◽  
Minute Walk

Abstract Background Anaemia and iron deficiency (ID) are important factors for muscle function and exercise capacity in patients with chronic heart failure (HF). Their interaction in HF remains to be defined. Methods A total of 280 out-patients with stable chronic HF were enrolled with mean age of 67.0±10.7 years, 21%female, mean left ventricular ejection fraction (LVEF) was 38.9±13.4%, mean Body Mass Index (BMI) 29.3±5.5 kg/m2]. Anaemia was defined according to World Health Organization criteria [Haemoglobin (Hb) <13 g/dL in men and <12 g/dL in women]. ID was defined as ferritin <100 μg/L or ferritin <100 <300 μg/L than with transferrin saturation (TSAT) <20%. Exercise capacity was assessed by spiroergometry (peakVO2), 6 minute walk test (6MWT), short physical performance battery test (SPPB), hang grip strength (HGS) and leg force (LF). All patients were followed up for a mean of 8 month. Results A total of 89 (32%) chronic HF patients had anaemia and 142 (51%) had iron deficiency at baseline. Patients with anaemia showed significant lower exercise capacity compared to patients without anaemia (peak VO2: 15.3±4.6 vs. 18.5±4.8 kg/min p<0.0001, 6MWT: 365.2±135.5 vs. 461.6±127.4 m p<0.0001, SPPB: 9.4±2.3 vs. 11.0±1.6 total points p<0.0001, HGS: 32.5±10.0 vs. 38.8±12.4 kg p<0.0001, LF: 31.4±11.0 vs. 41.3±21.6 kg p<0.0001). The same we found in patients with ID compared to patients without ID (peak VO2: 16.3±5.1 vs. 18.6±4.5 kg/min p=0.001, 6MWT: 400.0±140.8 vs. 458.8±128.4 m p=0.0008, SPPB: 10.0±2.1 vs. 10.9±1.7 total points p=0.0003, HGS: 34.5±11.9 vs. 39.3±11.7 kg p=0.001, LF: 35.7±23.4 vs. 40.5±13.6 kg p=0.04). After a Follow up of mean 8 month 53 patients develop a new onset of either anaemia (n=24) or ID (n=29). Logistic regression analysis showed that gender, 6 minute walk distance, SPPB, HGS and presence of diabetes mellitus at baseline are significantly associated with the development of anaemia or ID (all p<0.05). The strongest predictor was lower SPPB (p=0.0008). Interestingly known determinates lower peak VO2, higher age, higher NYHA class, Creatinine, and hsCRP were not predictive in our cohort to develop anaemia or ID after 8 month (all p>0.05). Conclusion Both anaemia and ID are strongly associated with reduced exercise capacity in patients with HF. The effect of anaemia and iron deficiency together is stronger than that of anemia and ID alone. Reduced SPPB, 6MWT, and HGS are important risk factors for the development of anaemia or ID.

scholarly journals Ischaemia-modified albumin in dilated cardiomyopathy

2009 ◽  
Vol 46 (3) ◽  
pp. 241-243 ◽  
Author(s):  
Eftihia Sbarouni ◽  
Panagiota Georgiadou ◽  
Maria Koutelou ◽  
Ioannis Sklavainas ◽  
Demosthenes Panagiotakos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Myocardial Necrosis ◽  
Heart Association ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Significant Difference

Background Biomarkers of myocardial necrosis may be increased in patients with chronic heart failure. We investigated whether ischaemia-modified albumin (IMA), a marker of ischaemia, is also elevated in patients with compensated heart failure, due to dilated cardiomyopathy (DCM). Methods We studied 42 patients with DCM and an equal number of age-matched normal volunteers. We assessed IMA serum levels with the albumin cobalt binding test. Results IMA was 89.9 ± 13.1 (71–117) KU/L in the patient group and 93.9 ± 9.9 (76–122) KU/L in the control group, with no significant difference between the two ( P = 0.11). However, IMA differed significantly according to the New York Heart Association classification ( P = 0.003) and was negatively correlated with the left ventricular ejection fraction ( r = −0.40, P = 0.014). Conclusions We conclude that IMA, a marker of ischaemia, does not differ in patients with clinically stable DCM compared with normal subjects, but varies significantly in relation to the severity of the disease.

scholarly journals Level of aurathrenomedullin in chronic heart failure of ischemic genesis: associations with clinical manifestations

2019 ◽  
Vol 18 (3) ◽  
pp. 81-89
Author(s):  
E. I. Myasoedova
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction

Objective. To identify and evaluate the relationship between the level of proadrenomedullin and clinical and anamnestic data of patients with chronic heart failure of ischemic genesis.Materials and methods. 240 men with chronic forms of coronary heart disease (mean age 55.9 [43; 63] years) and past Q-forming myocardial infarction were examined. Of these, 110 patients had chronic heart failure and preserved left ventricular ejection fraction (group 1) and 130 patients had chronic heart failure and dilatation with a low left ventricular ejection fraction (group 2). In all patients the MR-proADM level in the blood serum was determined.Results. In the control group, the level of MR-proADM was 0.49 [0.18; 0.58] nmol /l. In the meantime, it was statistically significantly higher in the studied groups of patients than in the control group (p < 0.001 and p < 0.001, respectively). And in the group of patients with chronic heart failure and dilatation with a low left ventricular ejection fraction, it was statistically significantly higher than in the group of patients with chronic heart failure and preserved left ventricular ejection fraction (1.72 [1.56; 1.98] nmol/l and 0.89 [0.51; 1.35] nmol/l, respectively, p < 0.038). The study demonstrated the presence of statistically significant associations between the level of MR-proADM and the severity of chronic heart failure and exertional angina pectoris as well as between the presence of a constant form of atrial fibrillation and the levels of systolic and diastolic blood pressure.Conclusion. MR-proADM is a new promising marker, which will be possible to use as a diagnostic standard for assessing the effectiveness of treatment of cardiac patients. 

scholarly journals Choroidal thickness changes in children with chronic heart failure due to dilated cardiomyopathy

2021 ◽  
Author(s):  
Klaudia Rakusiewicz ◽  
Krystyna Kanigowska ◽  
Wojciech Hautz ◽  
Lidia Ziółkowska
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Choroidal Thickness ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Healthy Children ◽  
Ventricular Ejection Fraction ◽  
Sd Oct

Abstract Purpose To evaluate choroidal thickness (CTh) in children with chronic heart failure (CHF) secondary to dilated cardiomyopathy (DCM) using spectral domain optical coherence tomography (SD-OCT) and to compare their values to those of healthy children. Methods Sixty eyes of thirty children (mean age 9.9 ± 3.57 years) with chronic heart failure (left ventricular ejection fraction, LVEF ≤ 55%) due to DCM lasting for over 6 months were prospectively enrolled. The control group consisted of 30 age- (mean age 10.16 ± 3.42 years) and sex-matched healthy children. All participants underwent transthoracic echocardiography with LVEF measured using the Simpson method and had the blood serum level of N-terminal-pro-brain natriuretic peptide marker (NT-proBNP) determined. All children underwent SD-OCT and had subfoveal choroidal thickness (SFCTh) and CTh measured at 1500 µm (μm) nasally, temporally, superiorly and inferiorly from the fovea in both eyes by two investigators. Results CTh at all locations was statistically significantly lower in children with DCM compared to the control group. Mean CTh in the group with CHF compared to the control group were (304.03 vs. 369.72 μm, p < 0.05) at the subfoveal location, (245.87 vs. 284 μm, p < 0.05) 1500 μm nasally from the fovea, (291.5 vs. 355.95 μm, p < 0.05) 1500 μm temporally from the fovea, (303.98 vs. 357.58 μm, p < 0.05) 1500 μm superiorly from the fovea and (290.92 vs. 344.96 μm, p < 0.05) 1500 μm inferiorly from the fovea. The average difference CTh between the study groups ranged from 38.13 to 65.69 μm at individual locations. In both groups, CTh was the thickest at subfoveal location (304.03 vs. 369.72 μm, p < 0.05) and the thinnest was 1500 μm nasally from the fovea (262.37 vs. 336.87 μm, p < 0.05). There was no correlation between CTh and age, gender, biometry and refractive error. No correlation was found between CTh and LVEF and NT-proBNP. Conclusion Patients with CHF due to DCM had a thinner CTh at all measured locations. The results of our research indicate that CHF affects CTh and this parameter may be very helpful in monitoring the clinical course of the disease in children with DCM.

scholarly journals CORRELATION BETWEEN CONCENTRATION OF PATHOLOGICAL CYTOKINES AND ERYTHROPOIETIN IN PATIENTS WITH CHRONIC HEART FAILURE WITH ANEMIC SYNDROME

2015 ◽  
Vol 69 (1-2) ◽  
pp. 32-37
Author(s):  
K. Kh. Zahidova
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Nyha Class ◽  
Heart Association ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
New York Heart Association ◽  
Erythropoietin Treatment

Aim: to study correlation between concentration of pathological cytokines and erythropoietin in patients with chronic heart failure with anemic syndrome and also to prove importance of this communication for need of appointment erythropoietin excitants. Patients and methods: 94 patients with chronic heart failure of New York Heart Association (NYHA) class ІІІ–ІV a left ventricular ejection fraction of 40% or less with anemia w ere included in investigation (58 males, 36 females). Anemia was detected when hemoglobin (Hb) was less than 120 g/l in males and less than 110 g/l in females. 46 patients received traditional treatment of CHF (І group) and 48 patients were treated additionally with erythropoietin (EPO) (ІІ group). Percutaneous EPO 50 IU monthly to patients without iron deficiency for a period of 6 months. Echocardiography parameters, plasma NT and pro-BNP, cytokines, EPO, ferritin and 6-minute walking test were assessed at baseline and after treatment. Results: in patients with CHF and anemia in ІІ group erythropoietin treatment increased Hb levels by 22,4% (p IL 6 by 54,3% (p α by 48,3% (p increase of LVEF by 19,04% (p Conclusions: Correction of anemia in patients with chronic heart failure with percutaneous erythropoietin injections 50 IU monthly for 6 month period to improve erythropoietin deficit and cytokines aggression and associated anemia, symptoms and quality of life.

scholarly journals Analysis of levels of oxidative stress markers depending on the left ventricular ejection fraction in patients with chronic heart failure

2018 ◽  
Vol 17 (5) ◽  
pp. 34-39
Author(s):  
E. A. Polunina ◽  
L. P. Voronina ◽  
E. A. Popov ◽  
O. S. Polunina
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Sod Activity ◽  
Ventricular Ejection Fraction

Aim.To study and analyze the levels of oxidative stress (OS) markers (malondialdehyde (MDA), superoxide dismutase (SOD), advanced oxidation protein products (AOPPs)) depending on the left ventricular ejection fraction (LVEF) and functional class (FC) in patients with chronic heart failure (CHF).Material and methods.We examined 60 somatically healthy individuals and 345 patients with CHF, which were divided into three main groups depending on the LVEF and subgroups depending on FC. The levels of OS markers were determined in blood serum — MDA, SOD and AOPPs.Results.In the group of patients with preserved LVEF and FC II-IV CHF, levels of MDA and AOPPs were statistically significantly higher, and the SOD level was lower compared to the control group. In the group of patients with moderately reduced and reduced LVEF, the levels of MDA and AOPPs were statistically significantly higher, and SOD activity was lower compared with the control group and the group of patients with CHF and preserved LVEF. In patients with CHF with higher FC, there was a statistically significant increase of MDA and AOPPs levels and decrease of SOD activity. The most pronounced changes in the levels of above-mentioned markers were recorded in patients with reduced LVEF. According to the correlation analysis a direct relationship between the levels of markers of the OS and clinical manifestations of the disease was found.Conclusion.Changes in levels of MDA, SOD and AOPPs in patients with CHF were detected already in the early stages of the disease compared with the control group. In patients with higher FC CHF and preserved, moderately reduced and reduced LVEF, a statistically significant increase in the levels of MDA and AOPPs and a decrease of SOD activity were observed. The most pronounced changes in the levels of the markers were indicated in patients with reduced LVEF.

scholarly journals Analysis of inflammatory marker levels in patients with chronic heart failure

2018 ◽  
Vol 17 (5) ◽  
pp. 47-52
Author(s):  
E. A. Popov ◽  
E. A. Polunina ◽  
L. P. Voronina ◽  
O. S. Polunina ◽  
I. S. Belyakova
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Rating Scale ◽  
Inflammatory Marker ◽  
Left Ventricular ◽  
Disease Stage ◽  
Left Ventricular Ejection ◽  
Clinical State ◽  
Control Group ◽  
Ventricular Ejection Fraction

Aim.To analyze the levels of fractalkine, neopterin and C-reactive protein (CRP) in patients with chronic heart failure (CHF) depending on the left ventricular ejection fraction (LVEF) and stage of the disease.Material and methods.We examined 340 people (280 patients with CHF) divided into groups depending on LVEF and stage of the disease (stage I-III). The control group consisted of 60 somatically healthy individuals. Levels of neopterin, fractalkine and CRP were indicated with the use of enzymoimmunoassay.Results.Compared with the control group, patients with CHF, regardless of LVEF and the stage of the disease, had hyperproduction of neopterin, fractalkine and CRP. We indicated correlations between the level of neopterin, fractalkine, CRP and Rating Scale of Clinical State (RSCS) scores, as well as with the results of 6-minute walk distance. Compared with patients with CHF IIA, patients with CHF IIB-III and preserved LVEF, had a decrease in levels of fractalkine, neopterin and CRP.Conclusion.Changes in levels of neopterin, fractalkine and CRP were detected in patients with CHF and preserved and reduced LVEF. More significant tendency to hyperproduction was noted in patients with reduced LVEF in the group of patients with CHF IIB-III.

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