MORPHOLOGICAL AND STRUCTURAL CHANGES IN MYOCARDIUM, LIPID AND CARBOHYDRATE METABOLISM DURING DIFFERENT OUTCOMES OF CHRONIC HEART FAILURE IN PATIENTS WITH ISCHEMIC HEART DISEASE AND DIABETES MELLITUS TYPE II

Ekaterina Lipakova, Oleksandr Bilchenko, Olena Vysotska, Liubov Rysovana

Abstract


Diabetes mellitus (DM) type II is an independent risk factor for cardiovascular system injury. To avoid progression of ischemic heart failure (IHF) it is important to find early signs of myocardial injury also as carbohydrate and lipid metabolism alterations.

The objective of the study: to establish features of structural and functional changes in myocardium, carbohydrate and lipid metabolism, in patients with different outcomes of chronic heart failure (CHF), caused by IHD and DM type II.

Material and methods. Examination of 100 patients who have CHF with IHF and DM type II was performed. Patients were divided in two groups, according to outcome: group I (n=66) – patients with favorable outcome, mean age 60.0 [55.8; 63.3] years, group II (n=34) – unfavorable outcome of CHF, mean age 58.0 [55.0; 60.3] years.

We analysed complaints, cardiologycal anamnesis, cardiovascular risk factors, and physical examination data. Transthoracic echocardiography (TTE), carbohydrate and lipid panel were assessed to find out early specific signs of myocardial injury.

Results. We find out statistically significant associations between TTE results, lipid panel and CHF progression in study population.

Conclusions. Comparative analysis showed that degree of CHF in patients with IHD and DM type II that have preserved LV EF is associated with: duration of DM and CHF, arterial hypertension (AH) level and degree of carbohydrate and lipid metabolism disturbances. Early TTE signs of unfavorable outcome are: increase of transmitral deceleration time (Dt), increase of mean PA pressure (PA MP) even in range lower the 20 mmHg.


Keywords


carbohydrate metabolism; lipid metabolism; myocardium morpho-functional state

Full Text:

PDF

References


Severino, P., D’Amato, A., Netti, L., Pucci, M., De Marchis, M., Palmirotta, R. et. al. (2018). Diabetes Mellitus and Ischemic Heart Disease: The Role of Ion Channels. International Journal of Molecular Sciences, 19 (3), 802. doi: https://doi.org/10.3390/ijms19030802

IDF Diabetes Atlas (2015). Available at: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/13-diabetes-atlas-seventh-edition.html

Kumar, R., Kerins, D. M., Walther, T. (2015). Cardiovascular safety of anti-diabetic drugs. European Heart Journal – Cardiovascular Pharmacotherapy, 2 (1), 32–43. doi: http://doi.org/10.1093/ehjcvp/pvv035

Stratton, I. M., Adler, A. I., Neil, H. A. et. al. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ, 321 (7258), 405–412. doi: http://doi.org/10.1136/bmj.321.7258.405

Chatterjee, S., Khunti, K., Davies, M. J. (2017). Type 2 diabetes. The Lancet, 389 (10085), 2239–2251. doi: http://doi.org/10.1016/s0140-6736(17)30058-2

Bowes, C. D., Lien, L. F., Butler, J. (2019). Clinical aspects of heart failure in individuals with diabetes. Diabetologia, 62 (9), 1529–1538. doi: http://doi.org/10.1007/s00125-019-4958-2

Jia, G., Whaley-Connell, A., Sowers, J. R. (2017). Diabetic cardiomyopathy: a hyperglycaemia- and insulin-resistance-induced heart disease. Diabetologia, 61 (1), 21–28. doi: http://doi.org/10.1007/s00125-017-4390-4

Yahagi, K., Kolodgie, F. D., Lutter, C., Mori, H., Romero, M. E., Finn, A. V., Virmani, R. (2017). Pathology of Human Coronary and Carotid Artery Atherosclerosis and Vascular Calcification in Diabetes Mellitus. Arteriosclerosis, Thrombosis, and Vascular Biology, 37 (2), 191–204. doi: http://doi.org/10.1161/atvbaha.116.306256

Saotome, M., Ikoma, T., Hasan, P., Maekawa, Y. (2019). Cardiac Insulin Resistance in Heart Failure: The Role of Mitochondrial Dynamics. International Journal of Molecular Sciences, 20 (14), 3552. doi: http://doi.org/10.3390/ijms20143552

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S. et. al. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37 (27), 2129–2200. doi: http://doi.org/10.1093/eurheartj/ehw128

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S. et. al. (2016). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC). European Heart Journal, 37 (27), 2129–2200. doi: http://doi.org/10.1093/eurheartj/ehw128 American diabetes association. Standards of Medical Care in Diabetes–2017 (2017). Diabetes Care, 40 (1), 135.

Klimov, A. N. (1977). Prichiny i usloviya razvitiya ateroskleroza. Preventivnaya kardiologiya, 260–321.

Celermajer, D. S., Sorensen, K. E., Gooch, V. M., Spiegelhalter, D. J., Miller, O. I., Sullivan, I. D. et. al. (1992). Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. The Lancet, 340 (8828), 1111–1115. doi: http://doi.org/10.1016/0140-6736(92)93147-f

Ivanova, O. V., Rogoza, T. V., Balakhonova, G. N. (1998). Opredelenie chuvstvitelnosti plechevoi arterii k napriazheniiu sdviga na endotelii kak metod ocenki sostoianiia endoteliizavisimoi vazodilatacii s pomoschiu ultrazvuka vysokogo razresheniia u bolnykh s arterialnoi gipertoniei. Kardiologiia, 3, 37–41.

Savarese, G., Lund, L. H. (2017). Global Public Health Burden of Heart Failure. Cardiac Failure Review, 3 (1), 7–11. doi: http://doi.org/10.15420/cfr.2016:25:2

Braunwald, E. (2015). The war against heart failure: the Lancet lecture. The Lancet, 385 (9970), 812–824. doi: http://doi.org/10.1016/s0140-6736(14)61889-4

Cleland, J. G. F., Bunting, K. V., Flather, M. D., Altman, D. G., Holmes, J. et. al. (2017). Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. European Heart Journal, 39 (1), 26–35. doi: http://doi.org/10.1093/eurheartj/ehx564

Udell, J. A., Cavender, M. A., Bhatt, D. L., Chatterjee, S., Farkouh, M. E., Scirica, B. M. (2015). Glucose-lowering drugs or strategies and cardiovascular outcomes in patients with or at risk for type 2 diabetes: a meta-analysis of randomised controlled trials. The Lancet Diabetes & Endocrinology, 3 (5), 356–366. doi: http://doi.org/10.1016/s2213-8587(15)00044-3

Lam, C. S. (2015). Diabetic cardiomyopathy: An expression of stage B heart failure with preserved ejection fraction. Diabetes and Vascular Disease Research, 12 (4), 234–238. doi: http://doi.org/10.1177/1479164115579006

Lehrke, M., Marx, N. (2017). Diabetes Mellitus and Heart Failure. The American Journal of Medicine, 130 (6), S40–S50. doi: http://doi.org/10.1016/j.amjmed.2017.04.010

Cosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V. et. al. (2019). 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. European Heart Journal, 41 (2), 255–323. doi: http://doi.org/10.1093/eurheartj/ehz486




DOI: http://dx.doi.org/10.21303/2504-5679.2020.001139

Refbacks

  • There are currently no refbacks.




Copyright (c) 2020 Ekaterina Lipakova, Oleksandr Bilchenko, Olena Vysotska, Liubov Rysovana

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 2504-5679 (Online), ISSN 2504-5660 (Print)