DECOMPENSATED CHRONIC HEART FAILURE COURSE IN DIABETES PATIENTS
https://doi.org/10.15829/1560-4071-2017-8-36-41
Abstract
Aim. To investigate on clinical, hemodynamic and laboratory specifics of heart failure course in diabetes mellitus type 2 (DM2) patients and non-diabetic, hospitalized due to acute decompensation of chronic heart failure (CHF).
Material and methods. Totally, 134 patients included, hospitalized to cardiology. All patients were selected to 2 groups: I (CHF and DM2, n=66; age 61,8±7,2 y. o., 28 males, 38 females), and group II (CHF non-DM, n=68; 62,3±7,7 y. o., 33 males, 35 females). Symptom assessments were done, with the score of clinical state in CHF (SCSC), electrocardiography (ECG) resting in 12 leads; transthoracal echocardioscopy; laboratory blood tests; chest x-ray; 6-minute walking test.
Results. Patients with CHF and DM2 were characterized by comparatively high functional class of CHF, severity of symptoms (by SCSC 13,7±2,2 versus 11,1±2,2 points, p<0,05) and more prominent morphofunctional changes of the heart: significant decrease in ejection fraction of the left ventricle (LV) by 5,5% and increase of deceleration time in early diastolic filling, followed by the decrease of E/A. The specifics found was followed by disordered biochemical parameters in DM2. Anamnesis of CHF and DM2 in the cohort made it to find out an insufficient (less than 80%) control of glycemia among CHF and DM2 patients regardless long lasting course of glycemia disorder.
Conclusion. Results of the conducted study demonstrate negative character of impact of DM2 on CHF course of ischemic and non-ischemic origin.
About the Authors
M. N. Mamedov
National Research Center for Preventive Medicine of the Ministry of Health
Russian Federation
Russian Federation
B. U. Mardanov
National Research Center for Preventive Medicine of the Ministry of Health
Domodedovskaya Central City Hospital
Russian Federation
Russian Federation
M. V. Poprygo
Domodedovskaya Central City Hospital
Russian Federation
Russian Federation
References
1. Kotseva K, Wood D, De Bacquer D, et al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2016;23(6):636-48
2. Owens AT, Brozena SC, Jessup M. New Management Strategies in Heart Failure. Circ Res. 2016 Feb 5;118(3):480-9
3. Bjorck LM, Lanitis M, Lappas G, et al. Mortality Trends 1987 to 2004 in 404,480 Hospitalized Heart Failure Patients with and without Diabetes. Circulation 2012;125:AP208
4. Mareev VY, Ageev FT, Arutyunov GP et al. National guidelines OSSN, RCS and RNMOT for the diagnosis and treatment of chronic heart failure (fourth revision). Journal of Heart Failure. 2013;7(81):379-472. Russian (Мареев В.Ю., Агеев Ф.Т., Арутюнов Г.П. и др. Национальные рекомендации ОССН, РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр). Журнал Сердечная Недостаточность. 2013;7 (81):379-472)
5. Fomin IV. Epidemiology of chronic heart failure in the Russian Federation. Proc.: Chronic Heart Failure [Ageev FT et al.] - M .: GEOTAR- Media, 2010. - p. 7-77. Russian (Фомин И.В. Эпидемиология хронической сердечной недостаточности в Российской Федерации. В кн.: Хроническая сердечная недостаточность [Агеев Ф.Т. и соавт.] – М.: ГЭОТАР- Медиа, 2010. – c. 7–77)
6. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J. 2012; 33(14):1787-847
7. Harjola VP, Follath F, Nieminen MS, et al. Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure. Eur J Heart Fail. 2010;12(3):239-48
8. Nilsson PM, Cederholm J, Zethelius BR, et al. Trends in blood pressure control in patients with type 2 diabetes: data from the Swedish National Diabetes Register (NDR). Blood Press 2011;20:348–54
9. Redon J, Cifkova R, Laurent S, et al. Mechanisms of hypertension in the cardiometabolic syndrome. J Hypertens 2009;27:441–51
10. Bertoni AG, Akwo EA, Bleumke DA, et al. Myocardial Contraction Fraction, Diabetes, and HeartFailure: The Multi-Ethnic Study of Atherosclerosis. Circulation 2012;125:AP243
11. Jarnert C, Melcher A, Caidahl K et al. Left atrial velocity vector imaging for the detection and quantification of left ventricular diastolic function in type 2 diabetes. Eur J Heart Fail. 2008; 10:1080-1087
12. Nagueh SF, Appleton CP, Gillebert TC et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiog. 2009; 10:165-193
13. Poelzl G, Auer J. Cardiohepatic syndrome. Curr Heart Fail Rep. 2015;12(1):68-78
14. Smetanin IN, Deev AD, Gratsiansky NA. Levels of total cholesterol and blood glucose levels - factors independently associated with the risk of death and hospitalization in patients with CHF. Cardiology. 2007; 47 (8): 12-16. Russian (Сметанина И.Н., Деев А.Д., Грацианский Н.А. Уровни общего холестерина и глюкозы крови – факторы независимо связанные с риском смерти и госпитализации у больных с ХСН. Кардиология. 2007;47 (8):12–16)
15. Roberto F, Opasich C, Tavazzi L. Heart failure: 181 questions and answers. France, 2003, 448 р.
16. Taskinen MR, Adiels M, Westerbacka J, et al. Dual metabolic defects are required to produce hypertriglyceridemia in obese subjects. Arterioscler Thromb Vasc Biol 2011;31:2144–2150
Review
For citations:
Mamedov M.N., Mardanov B.U., Poprygo M.V. DECOMPENSATED CHRONIC HEART FAILURE COURSE IN DIABETES PATIENTS. Russian Journal of Cardiology. 2017;(8):36-41. (In Russ.) https://doi.org/10.15829/1560-4071-2017-8-36-41
Views:
1155
Email this article 