Клінічні характеристики та перебіг рефрактерної серцевої недостатності в пацієнтів залежно від внесення до листа очікування на трансплантацію серця

The aim – to analyze the frequency and structure of complications in patients with refractory chronic heart failure depending on their inclusion on the waiting list for heart transplantation (HT).Materials and methods. A one-center retrospective analysis of 547 cases of patients with end-stage CHF treated between 2021 and 2024 was conducted. Patients were divided into two groups depending on whether they were listed for HT: Group A (n = 464, listed) and Group B (n = 83, not listed due to relative contraindications). Clinical, demographic, echocardiographic, hemodynamic, and laboratory data were analyzed. Results. Patients on the waiting list (Group A) were significantly younger and had a lower NYHA functional class, fewer comorbidities (arterial hypertension, obesity, history of stroke), better echocardiographic parameters (higher LVEF, TAPSE, lower IVC diameter, and LV wall thickness), and more favorable pulmonary hemodynamics compared to non-listed patients. Group A also showed significantly lower rates of repeated hospitalizations (60.1 % vs. 81.9 %, p = 0.001), severe complications such as ventricular arrhythmias, ICD implantation, cardiogenic shock, need for inotropic or mechanical circulatory support, renal replacement therapy, thromboembolic events, and pneumonia. Overall mortality was significantly lower in the listed group (21.1 % vs. 49.4 %, p = 0.001). Conclusions. Inclusion in the heart transplant waiting list is associated with fewer hospitalizations, reduced severe complications, and lower mortality, which is likely related to closer monitoring and advanced medical care in this group.