scholarly journals Circulating hepatocyte growth factor (HGF) in patients with comorbidity of chronic heart failure, type 2 diabetes mellitus and impaired lipid metabolism

2013 ◽  
Vol 16 (2) ◽  
pp. 17-25 ◽  
Author(s):  
Tatiana Nikolaevna Kochegura ◽  
P I Makarevich ◽  
A G Ovchinnikov ◽  
L V Zhigunova ◽  
Elena Leonidovna Lahova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Metabolism ◽  
Growth Factor ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection

AIM: To evaluate the plasma level of circulating heptocyte growth factor (HGF) in patients with comorbidity of post-infarction chronic heart failure (CHF), type 2 diabetes mellitus (T2DM) and obesity. We also aimed to assess possible correlations between HGF levels and parameters of carbohydrate and lipid metabolism, as well as myocardial functional characteristics and classic biochemical severity markers for CHF.17Сахар ный диабет КардиологияСахарный диабет. 2013;(2):17-25 MATERIALS AND METHODS: We enrolled 100 patients for participation in this study, including the following subgroups: 20 individuals with- out cardiovascular and glycemic disorders, 30 patients with CHF, 25 patients with CHF/T2DM comorbidity and 25 diabetic patients with no signs of heart failure. Quantitative plasma HGF analysis was performed with enzyme-linked immunosorbent assay (ELISA). RESULTS: Plasma HGF was elevated both in patients with CHF and T2DM as measured against healthy control group. The elevation was most prominent in patients with CHF/T2DM comorbidity and was found to correlate with HbA1c level (r=0.52, p=0.03). Plasma HGF also correlated with BMI (r=0.42, p=0007) in a unified study group, though we observed no statistically significant difference between subgroups with a trend toward higher HGF in obese patients with CHF/T2DM comorbidity (626.1?254.1 pg/ml vs 742.0?210.7 pg/ml respectively; p 0.05). Interestingly, plasma HGF was also significantly higher in controls with BMI 30 km/m2 (324.1?107.7 pg/ml vs 436.9?112.3 pg/ml, p=0.03).Circulating HGF correlated with plasma levels of N-terminal fragment of B-type natriuretic peptide (NT-proBNP) and such structural and functional myocardial characteristics as left atrial size and maximum volume along with left ventricular ejection fraction (EF), end-diastolic volume (EDV) and end-diastolic dimension (EDD). CONCLUSION: These findings suggest that HGF may potentially serve as a prediction marker for unfavorable myocardial remodeling and poor prognosis in CHF patients with T2DM and obesity, though this possibility should be further investigated in follow-up studies.

scholarly journals Influence of beta-blockers on mechanical dyssynchrony and cardiac remodeling in patients with ischemic chronic heart failure in the setting of revascularization

2019 ◽  
Vol 5 (1) ◽  
pp. 1-13
Author(s):  
Irina V. Askari ◽  
Olga A. Osipova
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Average Dose

Introduction: Diastolic dysfunction (DD) and cardiac dyssynchrony (DS) are involved in the progression of chronic heart failure (CHF). A comparative analysis was conducted of the effect of a 6-month course of nebivolol and bisoprolol on DD, DS and metalloproteinase-9 (MMP-9) level in patients with ischemic chronic heart failure with preserved ejection fraction (HFpEF) and with midrange ejection fraction (HFmrEF), as well as in patients with comorbid type 2 diabetes mellitus (T2DM) in the setting of coronary artery bypass grafting (CABG) after 6 months of therapy. Materials and methods: The study included 308 patients with CHFFC I-II, left ventricular ejection fraction (LVEF) >40%, who had undergone CABG. The average dose of nebivolol in patients with DS 6 months later was 5.1±2.6 mg/day, and bisoprolol – 4.9±2.4 mg/day. Echocardiography (EchoCG) and evaluation of MMP-9 in blood plasma were performed. Mechanical myocardial asynchrony was determined by calculating the standard deviation of time to peak systolic myocardial velocity (TS-SD) and maximum segment delay (TS12) using a 6-basal and-midsegment model. Results and discussion: MMP-9 level in patients with CHF before CABG was 4.7 times higher (p<0.001). MMP-9 correlated with LVEF (r=-0.60, p<0.001), E/A (r=-0.49, p<0.001), DT (r=0.43, p<0.001), E` (r=-0.58, p<0.001) and DS: TS12 (r=0.54, p<0.001), TS-SD (r=0.49, p<0.001). The six-month course of nebivolol improved the values of DS: TS12 – by 30% (p<0.001), TS-SD – by 32% (p<0.01) and reduced the MMP-9 level by 11% (p<0.001). In patients with HFmrEF without DSnebivolol increased E/A by 19% (p<0.01), E` – by 16% (P<0.05), and decreased E/E’ by 9% (p<0.05), DT – by 12% (p<0.05). In patients with HFpEF and DM2, nebivolol reduced TS12 by 37% (p<0.01), TS-SD – by 29% (p<0.05) and MMP-9 – by 13% (p<0.05). Conclusion: The positive effect of nebivolol on the DS, DD of the LV in patients with HFpEF, HFmrEF and with comorbid type 2 diabetes mellitus. The six-month course of nebivolol decreased the MMP-9 level in patients with ischemic CHF after CABG, including patients with T2DM.

scholarly journals The chronic heart failure early stage predictors in type 2 diabetes mellitus

2021 ◽  
pp. 4-16
Author(s):  
D.V. Grazhdankina ◽  
◽  
A.A. Demin ◽  
I.A. Bondar ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Duration Of Diabetes ◽  
Initial Symptoms

Introduction. Type 2 diabetes mellitus (T2DM) is considered to be the equivalent of cardiovascular disease due to its micro- and macrovascular complications. Insulin resistance and hyperinsulinemia, impaired glucose tolerance and fasting glucose, and their subsequent maladaptive responses lead to myocardial dysfunction several years before the onset of T2DM. Pathological changes in the cardiovascular system in T2DM can progress without any symptoms for a long time. Aim. To identify clinical, laboratory, echocardiographic predictors of the early manifestations of chronic heart failure (CHF) in patients with T2DM. Materials and methods. The study included 94 patients with T2DM with and without initial symptoms of CHF at the age of 40 to 65 years. All patients had obesity or excess body weight and arterial hypertension (AH), 37 patients had stable coronary heart disease (CHD). Patients underwent general clinical and laboratory examination, a 6-minute walk test (6MWT), echocardiography. The concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP ) was also determined. The patients were divided into 2 groups: without CHF symptoms (group 1, n = 54) and with initial symptoms of CHF (group 2, n = 40) and then these groups were compared. Results. Differences were revealed between the second and first groups in the duration of T2DM (10.5 vs 7.5 years, p = 0.02) and AH (15 vs 10 years, p = 0.009); the incidence of stable CHD (70 vs 16.7%, p < 0.0001); distance covered during 6MWT (375 vs 425 m, p < 0.0001); the median level of NT-proBNP (38.5 vs 27.2 pg/ml, p = 0.031); the left atrium (LA) size (4.4 vs 4.2 cm, p = 0.044); the left ventricular posterior wall thickness (PWT) (1.05 vs 0.95 cm, p = 0.02); the level of triglycerides (2.3 vs 1.6 mmol/l, p = 0.03) and the glomerular filtration rate (GFR) (74.1 vs 79.1 ml/min/1.73 m2, r = 0.04). The discriminant analysis revealed combination of factors associated with initial symptoms of CHF: the duration of CHD (taken as 0, if absent, p < 0.00001), PWT of the LV (p = 0.000007), GFR (p = 0.0009), the LA size (p = 0.005), the level of triglycerides (p = 0.03), the duration of T2DM (p = 0.046). The NT-proBNP level > 125 pg/ml was detected in 16% of patients with T2DM and correlated with the duration of diabetes over 10 years (p = 0.0085), the presence of stable CHD (p < 0.0001), and left ventricular mass index (p = 0.0005) and the ejection fraction of the LV (p < 0.0001). Conclusion. Predictors of the initial manifestations of chronic heart failure in patients with type 2 diabetes mellitus were the presence and duration of stable CHD, an increase in the PWT of the LV, the LA size, the level of triglycerides, and the duration of diabetes. An elevated level of NT-proBNP (more than 125 pg/ml) in patients with T2DM was detected in 16% of cases and was associated with the duration of diabetes for more than 10 years, presence of stable CHD, initial symptoms of CHF, left ventricular myocardial hypertrophy, and a lower left ventricular ejection fraction according to echocardiography.

scholarly journals Chronic heart failure and type 2 diabetes mellitus: prospects for optimizing pharmacotherapy of comorbid pathology

2021 ◽  
Vol 24 (1) ◽  
pp. 19-29
Author(s):  
Sergey V. Povetkin
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure ◽  
Cardioprotective Effect ◽  
Left Ventricular Ejection ◽  
Receptor Agonists ◽  
Positive Effect

The objective is to provide an overview of the literature data concerning the optimization of pharmacotherapy of comorbid pathology - chronic heart failure and diabetes mellitus. The article discusses the pathogenetic mechanisms of the negative mutual influence of chronic heart failure (CHF) and type 2 diabetes mellitus (T2DM) on their course and prognosis in patients with this comorbid pathology. Along with the discussion of the leading groups of drugs used for the treatment of CHF with a reduced left ventricular ejection fraction in patients with T2DM, priority classes of drugs for the treatment of patients with diastolic heart failure and their effect on the prognosis in the discussed contingent of patients are considered. An important area of therapy for people with CHF and T2DM is the use of hypoglycemic drugs that can have a positive effect on the course of cardiac pathology and change the prognosis in such patients. The article discusses the results of a number of randomized clinical trials evaluating the cardioprotective effect of modern classes of hypoglycemic agents: dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter-2 (SGLT-2) inhibitors. According to the presented studies, DPP-4 inhibitors, GLP-1 receptor agonists had a neutral or favorable effect on the prognosis in patients with cardiovascular diseases of atherosclerotic genesis and/or risk factors for their development, but did not affect the course of CHF. For the current period, the most significant drugs in terms of a positive effect on the prognosis in patients with diabetes mellitus and CHF are those from the SGLT-2 inhibitors group. The paper discusses in detail the results of clinical studies on the use of agents of the above-mentioned group in persons with CHF and diabetes mellitus and reviews the pharmacodynamic mechanisms that determine the cardioprotective effect of these drugs. The paper presents modern data that allow discussing the prospects for the use of SGLT-2 inhibitors in patients with CHF without T2DM.

scholarly journals Clinical and instrumental characteristics and five-year survival of men and women with chronic heart failure and reduced left ventricular ejection fraction depending on the presence of type II diabetes mellitus

2020 ◽  
Vol 27 (5) ◽  
pp. 60-70
Author(s):  
L. G. Voronkov ◽  
N. A. Tkach ◽  
O. L. Filatova ◽  
T. I. Gavrilenko ◽  
G. Ye. Dudnik ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Study Groups ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Atrial Size

The aim – to compare clinical and instrumental parameters and cumulative survival of women and men with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LV EF), depending on the presence of type II diabetes mellitus.Materials and methods. A retrospective analysis of 490 case histories of patients observed in the heart failure department in the period from 2011 to 2018, with CHF, II–IV NYHA functional class, LVEF ≤ 40 %, 40–80 years of age (median (quartiles)) – 64 (56.00; 69.00) years). The study group included mainly patients with coronary heart disease in combination with hypertension – 403 (82.2 %) patients, with isolated coronary heart disease – 55 (11.2 %) and with isolated hypertension – 32 (6.6 %). Most patients (278 (56.7 %)) had a permanent form of atrial fibrillation. Among the subjects were 373 (76.1 %) men and 117 (23.9 %) women. Comparisons were performed in populations of men and women depending on the presence of type 2 diabetes. Patients were included in the study in the phase of clinical compensation, in the euvolemic state.Results and discussion. The analysis revealed that the prevalence of type 2 diabetes mellitus in the population of men with CHF and reduced LV EF is significantly lower than in the female population. There were no significant differences between the study groups by etiology, the NYHA class, as well as the structure of comorbid conditions. Also there were no significant differences in age, mean daily heart rate, systolic and diastolic blood pressure. Despite expectations, insulin levels in both male and female cohorts did not differ significantly in patients with and without concomitant diabetes. In the cohort of men with CHF and reduced LV EF with concomitant diabetes the body mass index, anteroposterior left atrial size, GFR values were significantly higher, whereas the level of circulating citrulline and urea nitrogen were significantly lower compared to women. Women with CHF with reduced LV EF and concomitant diabetes compared to women without diabetes had lower LV EF and left atrial size, higher circulating citrulline levels, and E/е´ ratios. Analysis of the kidneys functional state showed deterioration of nitrogen excretory function in all study groups in the presence of type 2 diabetes mellitus. The five-year survival of men with CHF and reduced LV EF did not differ depending on the presence of type 2 diabetes mellitus. Instead, when analyzing the effect of type 2 diabetes mellitus on life expectancy in women with CHF and reduced LV EF, we observed a significantly worse prognosis.Conclusions. Woman with CHF and reduced LV EF with concomitant type 2 diabetes mellitus is characterized by a worse clinical course of the disease, which is combined with signs of more pronounced damage to target organs (heart, kidneys). At the same time, in women with diabetes, compared with men, the nitrogen-excreting renal function is significantly lower. Cumulative 5-year survival in the male cohort depending on presence of diabetes did not differ, while women with diabetes were characterized by significantly lower 5-year survival compared to women without diabetes.

scholarly journals Distribution of traditional Chinese medicine syndromes in type 2 diabetes mellitus with chronic heart failure

Medicine ◽  
2020 ◽  
Vol 99 (30) ◽  
pp. e21091
Author(s):  
Hui Wang ◽  
Jun Zhang ◽  
Chun-fang Shi ◽  
Jing Jia ◽  
Zhi-min Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chinese Medicine ◽  
Chronic Heart Failure ◽  
Traditional Chinese Medicine

Oxidative stress in patients with chronic heart failure and type 2 diabetes mellitus

2007 ◽  
Vol 143 (2) ◽  
pp. 207-209 ◽  
Author(s):  
N. E. Arzamastseva ◽  
V. Z. Lankin ◽  
G. G. Konovalova ◽  
A. K. Tikhaze ◽  
F. T. Ageev ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure

The clinical and experimental analysis of ventricular rhythm disturbances in the patients with type 2 diabetes mellitus suffering from diastolic cardiac insufficiency

2015 ◽  
Vol 61 (2) ◽  
pp. 21-27
Author(s):  
I P Tatarchenko ◽  
N V Pozdnyakova ◽  
A G Denisova ◽  
O I Morozova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cardiac Insufficiency ◽  
Left Ventricular Ejection ◽  
Ventricular Extrasystole ◽  
Ventricular Ejection Fraction

The present study was focused on the assessment of electrophysiological, structural, and functional characteristics of the heart associated with ventricular rhythm disturbances in the patients with type 2 diabetes mellitus (DM2) suffering from diastolic cardiac insufficiency. The study involved a total of 128 patients with DM2 and coronary heart disease (CHD) exhibiting signs of functional class I-III chronic cardiac insufficiency and left ventricular ejection fraction over 50%. The patients were divided into three groups. Group 1 (n=55) included patients presenting with left ventricular relaxation. Group 2 (n=44) was comprised of the patients with the pseudo-normal type of diastolic dysfunction. Group 3 (n=29) consisted of the patients with restrictive diastolic dysfunction. The patients of the latter group were characterized by the high frequency of complicated forms of ventricular arrhythmia, such as Grade IV-V ventricular extrasystole (48.3%) and Grade III ventricular extrasystole (34.5%). Restrictive type of diastolic dysfunction was associated with the delayed fragmented activity in the end part of the ventricular complex in 72.4% of the patients. The close correlation between the left ventricular diastolic function and parameters of myocardial electrical remodeling was documented.

scholarly journals EFFECT OF GLYCAEMIC CONTROL ON OUTCOME IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CHRONIC HEART FAILURE

2015 ◽  
Vol 65 (10) ◽  
pp. A886 ◽  
Author(s):  
Chim C. Lang ◽  
Daniel Levin ◽  
Mohapradeep Mohan ◽  
Helen Parry ◽  
Douglas Elder ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure ◽  
Glycaemic Control
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