THE EFFECT OF TYPE 2 DIABETES MELLITUS ON THE CLINICAL COURSE OF CHRONIC HEART FAILURE
- Authors: Pertsev A.V.1, Glavatskikh Y.O.1
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Affiliations:
- Voronezh State Medical University named after N. N. Burdenko
- Issue: Vol 12 (2023): MATERIALS OF THE XIX INTERNATIONAL BURDENKOVO SCIENTIFIC CONFERENCE APRIL 20-22, 2023
- Pages: 655-656
- Section: Medicine without frontiers
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/8367
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Abstract
Relevance. Chronic heart failure as the inevitable finale of almost all cardiovascular diseases occupies a leading position in the structure of overall mortality and persistent disability of the population, including those of working age. Based on a number of studies, a number of comorbid conditions have been identified that significantly affect the course and prognosis of CHF, one of these conditions includes diabetes mellitus.
The purpose of our research is to study the features of the clinical course of CHF in elderly patients with diabetes 2 type.
Materials and methods. The study included 800 people. All patients were diagnosed with CHF of ischemic genesis. The study participants were divided into two groups: Group 1 (with a combination of CHF and type 2 diabetes), the 2nd group (with CHF, without type 2 diabetes). The study analyzed the data of the clinical picture of the disease, the results of Echo-CG with the determination of the left ventricular ejection fraction, electrocardiography, chest X-ray examination, with 6 minute walking test (6MWT), ultrasound examinations of the abdominal cavity and kidney organs, clinical and biochemical blood tests, disease outcomes.
Results: Assessing the contractility of the left ventricle according to the Echo-CG, LV EF was taken into account: in group 1, LV EF was 48.5±8.5%, in group 2 LV EF - 54.8±10.3% (p = 0.002). Analyzing the data of the biochemical analysis of blood, it turned out that patients with CHF decompensation have a higher level of glycemia.
Conclusion. The features of the clinical course of CHF against the background of type 2 diabetes were revealed, which were expressed in a decrease in LV EF, a high level of glycemia in patients with type 2 diabetes. Higher rises with blood pressure, a decrease in tolerance to physical activity.
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Relevance: Chronic heart failure (CHF) as the inevitable finale of almost all cardiovascular diseases occupies a leading position in the structure of overall mortality and persistent disability of the population, including those of working age. Based on a number of studies, a number of comorbid conditions have been identified that significantly affect the course and prognosis of CHF, one of these conditions includes diabetes mellitus (DM) [1].
Objective: The purpose of our research is to study the features of the clinical course of CHF in elderly patients with diabetes 2 type.
Materials and methods: The study included 800 people, the average age of patients was 66.8±8.4 years (42% of men (336) and 58% of women (464). All patients were diagnosed with CHF of ischemic genesis. The study participants were divided into two groups in which the effect of type 2 diabetes on the progression of CHF in elderly patients with coronary artery disease was studied and compared. Group 1 included 182 people with a combination of CHF and type 2 diabetes, in the 2nd group 618 people with CHF, without a history of type 2 diabetes. The study analyzed the data of the clinical picture of the disease, the results of transthoracic echocardiography (Echo-CG) with the determination of the left ventricular ejection fraction (LVEF), electrocardiography (ECG), chest X-ray examination, with 6 minute walking test (6MWT), ultrasound examinations of the abdominal cavity and kidney organs, clinical and biochemical blood tests, disease outcomes. Statistical analysis was carried out using the Statistica 12 software package. The normality of the data distribution was assessed using a test (Shapira-Wilke). The initial continuous variables were presented as a standard mean deviation and compared using the Student t-criterion, in the form of a median and interquartile range, and compared using the Mann-Whitney and Kruskal-Wallis tests. Differences between subgroups were considered statistically significant at a significance level of p<0.05.
Results: Assessing the contractility of the left ventricle according to the transthoracic Echo-CG, LV EF was taken into account: in group 1, LV ЕF was 48.5±8.5%, in group 2 LV EF - 54.8±10.3% (p = 0.002). Analyzing the data of the biochemical analysis of blood, it turned out that patients with CHF decompensation have a higher level of glycemia (in group 1 8.1±1.8 mMol / l, and in 2 group 5.6±0.5 mMol / l) (p = 0.001). When conducting a correlation analysis of the relationship between LV FV and blood glucose levels in 1 group of patients, a noticeable correlation was found (r = -0.6). When evaluating the test results with 6MWT in group 1, shortness of breath appeared at a distance of up to 200 m (FC) III, and in group 2 at a distance of up to 400 m (FC I-II).
Discussion: Thus, assessing the relationship of the course of CHF against the background of type 2 diabetes, it can be concluded that the frequency of concomitant diabetes is 22.8% (182 people out of 800 patients), which confirms the data of many studies on the high prevalence of diabetes in persons with CHF.
Conclusion: The features of the clinical course of CHF against the background of type 2 diabetes were revealed, which were expressed in a decrease in LV EF of 48.5±8.5% (against 54.8±10.3% (p = 0.002)), a high level of glycemia (8.1±1.8 mMol / l) in patients with type 2 diabetes. Higher rises with blood pressure (level of blood pressure 148±19.1 mm Hg, against 136.3±11.9 mm Hg, (p = 0.023) and d ADI (91.8±11.2 mm Hg, were revealed, against 83.3±4.3 mmHg, (p = 0.017)), a decrease in tolerance to physical activity.
About the authors
Alexander V. Pertsev
Voronezh State Medical University named after N. N. Burdenko
Email: pertsev.vrn@yandex.ru
ORCID iD: 0000-0001-8984-1831
SPIN-code: 1432-9076
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia
Yuliya O. Glavatskikh
Voronezh State Medical University named after N. N. Burdenko
Author for correspondence.
Email: Yuliyag36@gmail.com
ORCID iD: 0000-0002-2398-5987
SPIN-code: 9762-6156
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia
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