Abstract
High prevalence of chronic heart failure (CHF) and type 2 diabetes (DM2), poor prognosis and low life quality determine the aim for optimum treatment strategy invention. Cornerstone of the treatment in this category of patients is correction of endothelial dysfunction and metabolism disorders that underlie development and progression of CHF and DM2: lipid- and glucose toxicity, insulin resistance (IR). Aim. To study the effects of taurin treatment as part of combination therapy for CHF with DM2, taking its influence on endothelial dysfunction. Material and methods. Totally, 60 patients included, after myocardial infarction (MI) lasting 6-12 months, with CHF I-III functional class and comorbid DM2. They were selected to 2 groups: 1st (controls) — patients receiving CHF treatment in postinfarction period and oral glucose lowering drugs, and 2nd (experimental) — patients also taking taurin 500 mg b.i.d. together with CHF and DM2 treatment. Assessment included 6-minute walking test, measurement of brain natriuretic peptide (NT-proBNP) in blood, echocardiography, vascular components of endothelium functioning, plasmatic factors of endothelial function (NO metabolites concentration and endotheline-1 in serum), glucose level, insulin with IR-index, glycosilated hemoglobine, total cholesterol, low density and high density lipoproteides, triglycerides. Results. It is found, that taurin shows endothelium protecting properties when used as part of combination therapy for CHF and DM2. These properties were noted on microcirculatory (significant in spastic pattern of disorder) level and in elastic arteries. While taking taurin, there was statistically significant increase of NO level in blood and decrease of endotheline-1. Conclusion. Positive endothelium protecting properties of taurin as part of combination therapy of CHF with DM2 were followed by significant decrease of CHF severity by NT-proBNP levels dynamics, and significant hypolipidemic effect, decrease of IR.
Highlights
High prevalence of chronic heart failure (CHF) and type 2 diabetes (DM2), poor prognosis and low life quality determine the aim for optimum treatment strategy invention
60 patients included, after myocardial infarction (MI) lasting 6-12 months, with CHF I-III functional class and comorbid DM2. They were selected to 2 groups: 1st — patients receiving CHF treatment in postinfarction period and oral glucose lowering drugs, and 2nd — patients taking taurin 500 mg b. i.d. together with CHF and DM2 treatment
That taurin shows endothelium protecting properties when used as part of combination therapy for CHF and DM2
Summary
ЭД является фактором прогрессирования и неблагоприятного прогноза ХСН [2], всех неблагоприятных событий при ХСН, независимым предиктором смертности от нее [3, 4]; степень выраженности ЭД коррелирует с тяжестью и функциональным классом (ФК) ХСН [5]. Важная роль в патогенезе ЭД принадлежит внутриклеточному окислительному стрессу, имеющему место как при ХСН, так и СД-2, поэтому представляется перспективным включение в комплексную терапию этих пациентов препаратов, обладающих антиокислительными свойствами, имеющими доказательную базу в лечении ССЗ при их применении per os. Активно обсуждаются потенциальные возможности таурина в профилактике и лечении осложнений СД [8], а также возможность влияния на сосудис тый тонус, степень выраженности ЭД [9], в т. Целью исследования было изучение влияния таурина в составе базисной терапии ХСН и СД-2 на тяжесть сердечной недостаточности, состояние эндотелиальной функции, инсулинорезистентность (ИР), углеводный и липидный обмены
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