SELECTION AND SYNTHESIS OF GENERAL MECHANISMS FOR FORMATION OF CHF IN COMORBID PATHOLOGY

The work analyses the pathogenesis of chronic heart failure (CHF) with preserved ejection fraction (EF); General mechanisms of CHF formation in concomitant diseases are outlined; Modern data on the effect of co morbid pathology on cardiac remodelling and dysfunction in patients with chronic heart failure with a preserved EF are summarized. Russian and foreign literary sources presented in the search engines were analyzed for the work. Analysis of the scientific literature has shown that an increase in systemic vascular inflammation, endothelial dysfunction and oxidative stress lead to a decrease in the bioavailability of nitric oxide (NO), an increase in LV stiffness and unfavourable remodelling in CHF with a preserved EF. Concomitant diseases such as overweight / obesity, diabetes, hypertension, chronic obstructive pulmonary disease, anaemia and chronic renal dysfunction lead to coronary remodelling through micro vascular endothelial inflammation. Demographic characteristics, such as the elderly age and the female gender, also contribute negatively. Generalizing the analysis of literature sources of the pathogenesis of CHF with comorbid pathology, it is concluded that in addition to left ventricular (LV) diastolic dysfunction, there are other pathophysiological mechanisms that affect cardiac function: disruption of reserve function, violation of the ventricular-arterial relationship, myocardial energy deficit, pulmonary hypertension, Chronotropic imbalance, inflammation, oxidative stress and endothelial dysfunction. Keywords: Chronic heart failure; accompanying illnesses; comorbidity; mortality; endothelial dysfunction; review