MORPHOLOGICAL AND STRUCTURAL CHANGES IN MYOCARDIUM, LIPID AND CARBOHYDRATE METABOLISM DURING DIFFERENT OUTCOMES OF CHRONIC HEART FAILURE IN PATIENTS WITH ISCHEMIC HEART DISEASE AND DIABETES MELLITUS TYPE II

Diabetes mellitus (DM) type II is an independent risk factor for cardiovascular system injury. To avoid progression of ischemic heart failure (IHF) it is important to find early signs of myocardial injury also as carbohydrate and lipid metabolism alterations.

The objective of the study: to establish features of structural and functional changes in myocardium, carbohydrate and lipid metabolism, in patients with different outcomes of chronic heart failure (CHF), caused by IHD and DM type II.

Material and methods. Examination of 100 patients who have CHF with IHF and DM type II was performed. Patients were divided in two groups, according to outcome: group I (n=66) – patients with favorable outcome, mean age 60.0 [55.8; 63.3] years, group II (n=34) – unfavorable outcome of CHF, mean age 58.0 [55.0; 60.3] years.

We analysed complaints, cardiologycal anamnesis, cardiovascular risk factors, and physical examination data. Transthoracic echocardiography (TTE), carbohydrate and lipid panel were assessed to find out early specific signs of myocardial injury.

Results. We find out statistically significant associations between TTE results, lipid panel and CHF progression in study population.

Conclusions. Comparative analysis showed that degree of CHF in patients with IHD and DM type II that have preserved LV EF is associated with: duration of DM and CHF, arterial hypertension (AH) level and degree of carbohydrate and lipid metabolism disturbances. Early TTE signs of unfavorable outcome are: increase of transmitral deceleration time (Dt), increase of mean PA pressure (PA MP) even in range lower the 20 mmHg.

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