Features of course and treatment of chronic heart failure in patients with diabetes mellitus type 2

Abstract

The epidemiology of chronic heart failure in patients with diabetes mellitus type 2, their general pathophysiological mechanisms, the influence of diabetes mellitus type 2 on the course and prognosis of chronic heart failure are considered. The high prevalence of chronic heart failure of all phenotypes among patients with diabetes mellitus type 2 and the increased risk of developing diabetes mellitus type 2 in patients with chronic heart failure confirm the close relationship and the high degree of comorbidity between these pathological conditions. It is shown that the development and progression of chronic heart failure in patients with diabetes mellitus type 2 is the formation of diabetic cardiomyopathy, which is characterized by disorders of energy metabolism of cardiomyocytes, mitochondrial dysfunction with subsequent apoptosis and myocardial fibrosis. Important links in the pathogenesis of chronic heart failure in diabetes mellitus type 2 are also the accession of diabetic cardiovascular autonomic neuropathy, activation of the renin-angiotensin-aldosterone system, endothelial dysfunction, exposure to atherogenic factors, arterial hypertension, obesity. The features of treatment of chronic heart failure in patients with diabetes mellitus type 2, the results of randomized clinical studies, the choice of target glycemic levels, the effectiveness of different groups of antihyperglycemic agents, drugs for the treatment of chronic heart failure, as well as their impact on the course and prognosis of chronic heart failure. Keywords: chronic heart failure, diabetes mellitus type 2, course, prognosis, treatment.