[The clinical features of heart failure in elderly and old age]

The aim of the study: To evaluate the prevalence and clinico-functional features of myocardial dysfunction in persons 65 years or older in the primary care seting.

Materials and methods: The prospective cohort study "Crystal" included participants 65 years and older. The arm of "Crystal" study evaluated a random sample size of 284 people. All participants were performed echocardiography using portable digital ultrasound scanner Mindray M5 ultrasound transducer of 2.5-3.5 MHz. It was also evaluated the clinical manifestations of heart failure (HF) on the scale SHOCKS, medical history and anthropometric data and parameters of the geriatric examination. Were determined muscle strength, walking speed, emotional status (Geriatric Depression Scale) and cognitive status (MiniMental State Examination). Assessment of dependence on external assistance was carried out based on the Barthel Index (Barthel Index).

Results: The prevalence of all forms of myocardial dysfunction was 80.3%, among them of 73.2% of participants had clinical manifestations of heart failure, which was not associated with type or severity of structural and functional abnormalities of the myocardium. Symptoms and signs of HF were characterized by low sensitivity for detection in older people with MD and may be associated with other conditions. The most common complaint was shortness of breath (59%), with high sensitivity for the diagnosis (89%) but low specifcity (51%). Patients with clinical manifestations of HF are more likely to have a BMI of over 30 kg/m2, cognitive disorders, suspected depression, lower walking speed and low grip strength by dynamometry. In addition, participants with symptoms were older age (75,3±5.6 years vs 72,7±5.5 years, p.