Динаміка показників кардіогемодинаміки у хворих на гострий інфаркт міокарда з супутнім цукровим діабетом 2 типу протягом 6 місяців спостереження

Abstract

The purpose of the study was to monitor the dynamics of cardiohemodynamics in patients with acute myocardial infarction in combination with type 2 diabetes mellitus during 6 months of follow-up. Materials and methods. The study involved 120 patients: group 1 – patients with acute myocardial infarction with type 2 diabetes mellitus (n = 70), group 2 – patients with acute myocardial infarction (n = 50). The control group included 20 healthy individuals. All patients underwent general instrumental and clinical examinations. In the course of echocardiographic (echocardiography) study, the parameters of the left ventricle were determined and calculated: end diastolic volume, end systolic volume, end diastolic size, end systolic size, posterior thickness, the thickness of the interventricular septum, the ejection fraction of the left ventricle, the size of the left atrium, the size of the aorta, stroke volume. Results and discussion. The average indicators of cardiohemodynamics on the first day of hospitalization were as follows: end diastolic volume in patients of the 1st group was 165.85±36.22 ml; of the 2nd – 133.44±27.19 ml; control – 54.54±21.48 ml; end systolic volume – 104.57±28.86 ml; 77.93±21.56 ml; 21.69±7.49 ml, respectively; end diastolic size – 5.74±0.6 ml; 5.22±0.49 ml; 3.55±0.58 ml, respectively; end systolic size – 4.66±0.62 ml; 4.11±0.52 ml; 2.41±0.32 ml, respectively; the ejection fraction of the left ventricle – 37.51±6.27%; 42.9±7.45%; 56.75±7.22%, respectively; posterior thickness – 1.37±0.13 cm; 1.32±0.13 cm; 1.07±0.08 cm, respectively; the thickness of the interventricular septum – 1.26±0.11 cm; 1.27±0.11 cm; 1.13±0.08 cm, respectively; the size of the left atrium – 4.07±0.31 cm; 3.75±0.46 cm; 3.19±0.15 cm, respectively; the size of the aorta – 3.39±0.27 cm; 3.3±0.22 cm; 2.97±0.16 cm, respectively; stroke volume – 60.27±13.3 cm3; 2nd – 57.01±10.72 cm3; 28.39±12.38 cm3, respectively. Six months after acute myocardial infarction, a positive trend in cardiohemodynamic parameters was observed, maintaining a tendency for worse indicators in the presence of acute myocardial infarction. Conclusion. Thus, impaired carbohydrate metabolism in the form of insulin resistance, hyperinsulinemia and stress hyperglycemia on the background of coronary events in type 2 diabetes mellitus leads to negative changes in geometry, mass, systolic and diastolic function of the left ventricle, which must be paid special attention to hemodynamic predictors of cardiovascular complications and heart failure