Abstract
Purpose: To study cardiac remodeling in patients with arterial hypertension (AH) and acute coronary syndrome (ACS) complicated with diabetes mellitus (DM) through analysis of laboratory parameters and echocardiogram. Methods: A total of 67 patients were prospectively enrolled (age range: from 36 to 79 years; average: 60,96 ± 9,22 years) with AH and ACS who were admitted to Emergency Hospital. The patients were divided into 2 groups depending on the presence of DM: 23 patients with DM (age average: 65,09 ± 7,73 years) and 44 without DM (age average: 58,79 ± 9,19 years). Serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), high sensitive C reactive protein (hs-CRP), antibodies to LPS General Enterobacteriaceae, antibodies to LPS Re-Glycolipid were tested for all patients. Echocardiograms were obtained on all the patients, interventricular septal thickness (IVSd) and others parameters were measured by taking the mean values of three continuous heartbeat cycles in the expiratory state. All indicators were calculated using the statistics program Statistica, a P-value of < 0,05 was considered statistically significant. Results: There were no significant differences in the levels of serum hs-CRP, TC, HDL-C, LDL-C; but TG levels were significantly higher in patients with DM ( 3,16 ± 2,61 mmol/l) than in controls (1,75 ± 1,33 mmol/l, p<0,05). Serum antibodies to LPS General Enterobacteriaceae levels (441,52 ± 303,70 A.U.O.D) were also significantly higher in the DM group than in controls (271,41 ± 200,13 A.U.O.D, p<0,05). The levels of serum antibodies to LPS General Enterobacteriaceae were positively correlated with IVSd (r = 0,765, p<0,05). Conclusion: The data demonstrated, that patients with DM and AH have a greater immune response which correlates with indicators of left ventricular remodeling. The mechanism of the cardiac function impairment, however, has not been clearly explained yet. The role of the immune response in the development of cardiac muscle remodeling is not fully understood. It Is currently considered that these changes may participate in the pathological process of left ventricular remodeling in patients with AH and DM.
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