Cardiovascular remodeling in patients with diabetic сardiomyopathy

Abstract

Aim . To assess cardiovascular remodeling in patients with diabetic cardiomyopathy (DCM) and compare it with healthy individuals. Material and methods . Among outpatients with newly diagnosed type 2 diabetes (T2D), according to inclusion and exclusion criteria, a group of participants with diabetic cardiomyopathy (DCM) with left ventricular diastolic dysfunction (LV DD) was made before treatment. The second group consisted of healthy individuals of the corresponding age. The structural and functional state of the heart was studied using echocardiography and determination of the N-terminal prohormone of the brain natriuretic peptide (Nt-proBNP) in the blood; of the arteries — using volume sphygmoplethysmography. Markers of fibrosis were determined in the blood: tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and C-terminal telopeptide 1 (CTP-1). Results . The DMC prevalence in patients with newly diagnosed T2D was 18,7%. LV DD was associated not only with T2D, but also with obesity (r=0,48; p=0,029), blood pressure even in the normal range ((r=0,42; p=0,031 for systolic blood pressure; (r=0,39; p=0,042) for diastolic blood pressure). The Nt-proBNP levels in the normal range and TIMP-1 were higher in the DCM group compared with the group of healthy individuals (p<0,001 and p<0,001, respectively). CTP-1 was lower in the first group compared with the second (p<0,001). In the DCM group, a higher cardioankle vascular index (CAVI1) was recorded compared to the group of healthy individuals (p<0,001). Conclusion . LV DD cannot be presented as a pathognomonic criterion for DCM. Nt-proBNP levels in the normal range of 76,23+14,47 pg/ml, which do not reach the diagnostic criteria for heart failure, an increase in TIMP-1 and a decrease in CTP-1 can be considered as additional markers of DCM. Given the fact that two parallel processes occur during the DCM formation, manifested by cardiac and arteries’ remodeling, the CAVI1 can also be considered as an additional DCM marker.