Aspects of chronic heart failure in patients with type 2 diabetes mellitus after implantation of a permanent pacemaker, depending on body weight

Abstract

The course of chronic heart failure (CHF) had been analyzed in patients with type 2 diabetes mellitus (DM) who had undergone pacemaker implantation, depending on body mass index (BMI). A retrospective analysis of echocardiographic data was carried out in 203 CHF patients who underwent pacemaker implantation, among whom 102 had concomitant type 2 diabetes (main group) and 101 participants did not have this metabolic pathology (control group). Pacemaker implantation was considered effective when the left ventricular end-diastolic volume (LV EDV) increased by 15 % after 12 months after operation. Patients who did not reach the target value of LV EDV were considered non-responders; analyzed the left ventricular ejection fraction (LVEF). In the main group, 22 patients (21,57 %) did not respond to implantation of the pacemaker, in the control group 12 people (11,9 %) did not respond to implantation of the pacemaker. Among the nonresponders, obese persons of the I, II and III degrees predominated. In the cohort of persons who responded to the establishment of the pacemaker, patients with a normal and increased BMI predominated; recorded a significant (p<0,001) increase in the mean values of LVEF in patients with normal BMI from (52,0±0,8) % to (61,4±0,8) %. Similar changes were noted in overweight patients: LVEF significantly (p<0,05) increased from (47,7±1,4) % to (55,1±1,3) %. Patients with CHF with concomitant type 2 diabetes, requiring pacemaker, have an inherent decrease in LVEF, which progressively decreases with increasing BMI. Low LVEF values are characteristic to patients with chronic heart failure, type 2 diabetes and morbid obesity. A good response to pacemaker implantation is associated with a normal, elevated BMI; failure to achieve the target value of LV EDV and insufficient growth of LVEF is more often recorded in the presence of concomitant obesity, especially of the II and III degrees. Keywords: heart failure, pacemaker, diabetes mellitus, left ventricular ejection fraction.