Зміни діастолічної функції лівого шлуночка у хворих на ішемічну хворобу серця в залежності від ступеню важкості цукрового діабету 2 типу

Abstract

The purpose of the study was to determine the characteristics of changes in the diastolic function of the left ventricle in patients with coronary heart disease and type 2 diabetes mellitus of various degrees of severity. Materials and methods. The study included 106 patients with an average age of 68.8 ± 8.9 years (46.2% men (average age 65.2 ± 9.0 years) and 53.9% women (average age 71.6 ± 7.8 years)) with isolated coronary heart disease and in comorbidity with type 2 diabetes mellitus of various degrees of severity, which formed 4 research groups: the first group included 36 patients with a monocourse of coronary heart disease (average age 66.4 ± 10.1 years); the second group included 21 patients with coronary heart disease and mild type 2 diabetes mellitus (average age 71.9 ± 9.4 years); the third group – 28 people with coronary heart disease and type 2 diabetes mellitus of an average degree of severity (average age 69.7 ± 8.0 years) and the fourth group – 21 patients with coronary heart disease and type 2 diabetes mellitus with a severe course (average age 67.9 ± 6.5 years). All patients were receiving inpatient treatment in the cardiology department of the Communal Non-Profit Enterprise “City Clinical Hospital No. 27”. Results and discussion. The study showed that systolic blood pressure values are significantly higher in patients with coronary heart disease and moderate type 2 diabetes mellitus. In all groups of patients, the average values of both systolic and diastolic blood pressure were above normal values, which indicates the presence of hypertension. The average values of diastolic blood pressure increased with increasing severity of the course of type 2 diabetes mellitus. Regular reliable differences were found in the mean values of glucose metabolism indicators between groups. Also, triglyceridemia was reliably noted in patients with type 2 diabetes mellitus with a severe course. In the data of the patients, a predominance of very low-density lipoprotein cholesterol concentrations was also noted. The vast majority of lipid metabolism indicators were within the reference values, which may be due to the effect of hypolipidemic therapy. Conclusion. The analysis showed that the value of the time of isovolumetric relaxation of the left ventricle and the time of slowing down of the E peak, which is a strong indicator of the development of diastolic dysfunction, increase significantly with the increasing severity of type 2 diabetes mellitus. At the same time, the values of the ejection fraction in the research groups of patients did not differ significantly and were almost at the same level, which indicates the long-term preservation of the systolic function of the heart and the possible development against this background of isolated diastolic dysfunction in patients with concomitant coronary heart disease and type 2 diabetes mellitus