scholarly journals Сlinical and hemodynamic characteristics and coronary blood flow in patients with chronic coronary artery disease and type 2 diabetes

2021 ◽  
Vol 26 (12) ◽  
pp. 4639
Author(s):  
B. U. Mardanov ◽  
M. A. Kokozheva ◽  
F. B. Shukurov ◽  
B. A. Rudenko ◽  
M. N. Mamedov
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Chronic Coronary Artery Disease ◽  
Group I ◽  
Hemodynamic Characteristics ◽  
Artery Disease

Aim. To assess the features of clinical and hemodynamic characteristics and the severity of coronary involvement in patients with chronic coronary artery disease (CAD) with and without diabetes.Material and methods. The study included 100 patients with stable CAD, which were divided into two groups: group I (mean age, 57,9-1,04 years, male/female 35/14) — 49 patients with CAD and type 2 diabetes, II — (60,2-0,9 years, 34/17) — 51 patients without SD. Along with behavioral and biological risk factors, clinical and hemodynamic characteristics were analyzed. All patients underwent coronary angiography.Results. The presence of diabetes in patients with CAD was associated with abdominal obesity and comorbidity of somatic diseases. Among group I patients, electrocardiographic signs of left ventricular hypertrophy, conduction abnormalities, accompanied by a decrease in the left ventricular ejection fraction, impaired diastolic function, and high mean pulmonary artery pressure were significantly more often detected. In patients with CAD and type 2 diabetes, significant right coronary artery (CA) stenoses were more often recorded (39%), while in patients without diabetes, the anterior descending artery was the most susceptible to atherosclerosis. In group I, stenosis of the distal CA third was detected 1,5 times more often (p<0,001), and their diffuse multivessel lesion prevailed by 28% (73% and 45%, respectively, p<0,005). The average SYNTAX score in patients with and without diabetes was 29,2±0,8 vs 22±0,7, respectively (p<0,0005).Conclusion. In patients with CAD and diabetes, more pronounced atherosclerotic coronary involvement (diffuse multivessel CAD) was revealed, which should be taken into account when planning further treatment. The risk of adverse cardiovascular events will always be present with percutaneous coronary interventions.

scholarly journals Effects of liraglutide on diastolic function parameters in patients with type 2 diabetes and coronary artery disease: a randomized crossover study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Preman Kumarathurai ◽  
Ahmad Sajadieh ◽  
Christian Anholm ◽  
Ole P. Kristiansen ◽  
Steen B. Haugaard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Trial Registration ◽  
Left Ventricular Ejection ◽  
Artery Disease

Abstract Background Diastolic dysfunction is highly prevalent in patients with type 2 diabetes mellitus (T2DM) and is associated with overweight, glucose dysregulation and coronary artery disease (CAD). The GLP-1 receptor agonist, liraglutide, has shown to induce weight loss and improve metabolic factors, thus modulating factors associated with diastolic dysfunction. We have previously reported the effects of liraglutide on systolic function, and in this current study we explore the effects of liraglutide on diastolic function parameters in patients with stable CAD, preserved left ventricular ejection fraction (LVEF), and newly diagnosed T2DM. Methods Thirty subjects were randomized to liraglutide or placebo intervention for 12 + 12-weeks in this double-blind cross-over study. 2D-echocardiography using tissue velocity imaging was used for assessment of diastolic function parameters. Early diastolic filling velocity (E), late atrial filling velocity (A), E-wave deceleration time (EDT) and E/A ratio was assessed from the pulse wave (PW)-Doppler velocity recording of the mitral inflow. Peak early diastolic annular velocities (e′) was measured from color tissue doppler images. Results Liraglutide, when compared to placebo, induced a significant reduction in average e′ and lateral e′ velocities (– 0.57 cm/s [– 1.05 to − 0.08] and –0.74 cm/s [–1.32 to –0.15], respectively). Adjusted for the concomitant increase in HR (+ 6.16 bpm [0.79 to 11.54], the changes were not significant. No significant changes in other diastolic function parameters were observed. Conclusions Liraglutide therapy did not improve any diastolic function parameters in subjects with T2DM, CAD, and preserved LVEF. Instead, a deterioration in e’ was observed, which was associated to an increase in heart rate induced by liraglutide therapy. Trial registration Clinical Trial Registration: http://www.clinicaltrials.gov (unique identifier: NCT01595789) (first submitted May 8, 2012)

scholarly journals Assessment of structural and functional myocardial characteristics in patients with chronic coronary artery disease and various glycemic status

2021 ◽  
Vol 20 (7) ◽  
pp. 3077
Author(s):  
M. A. Kokozheva ◽  
B. U. Mardanov ◽  
E. A. Poddubskaya ◽  
V. A. Kutsenko ◽  
M. A. Umetov ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Exercise Tolerance ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Control Group ◽  
Glycemic Status ◽  
Artery Disease

Aim. To study the structural and functional myocardial characteristics in patients with exertional angina and type 2 diabetes in comparison with those without diabetes to identify combined hemodynamic changes.Material and methods. Patients were divided into two groups depen - ding on the glycemic status. The first group consisted of 49 patients (mean age, 57,9±1,04 years; male/female, 35/14) with coronary artery disease (CAD) and type 2 diabetes, while the second one (control)  — 51 patients (60,2±0,9 years, 34/17) with CAD and without diabetes. Patients were surveyed using a standard questionnaire that included socio-demographic parameters, behavioral risk factors, clinical status, medications received, and comorbidities. Diagnostic investigations were carried out, including resting electrocardiography, transthoracic echocardiography and cycle ergometry.Results. Among patients with CAD and type 2 diabetes, hypertension occurred 20% more often compared with the control group  — 98 vs 78% (p<0,004). According to the electrocardiography, the combination of diabetes and CAD was characterized by various arrhythmias, which were recorded 2,8 times more often than in the group without diabetes. According to echocardiography, signs of left ventricular hypertrophy, systolic and diastolic dysfunction prevailed in people with diabetes. Mean pulmonary artery pressure in patients with diabetes were higher than in patients without carbohydrate metabolism disorders (p<0,004). According to the stress test, exercise tolerance in experimental group patients was lower than in patients in the control group.Conclusion. The combination of chronic CAD and type 2 diabetes is cha - racterized by a more common combination with hypertension, impaired central and intracardiac hemodynamics, as well as left ventricular hypertrophy. In people with diabetes, impaired systolic and diastolic myocardial function is combined with reduced exercise tolerance.

scholarly journals TGF-β and FRF-21: association with coronary artery disease in patients with type 2 diabetes and obesity

2017 ◽  
Vol 14 (3) ◽  
pp. 38-42
Author(s):  
Teona A. Shvangiradze ◽  
Irina Z. Bondarenko ◽  
Ekaterina A. Troshina ◽  
Larisa V. Nikankina ◽  
Svetlana S. Kukharenko ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Growth Factor ◽  
Left Ventricular ◽  
Fibroblast Growth Factor 21 ◽  
Control Group ◽  
Increased Risk ◽  
Artery Disease

Backgraund: Obesity and type 2 diabetes mellitus (T2DM) are associated with with an increased risk of cardiovascular disease (CVD) and coronary artery disease (CAD), in particular. Obesity lead to several fibrotic processes, including activation of transforming growth factor (TGF-). Recent data indicate the involvement of Fibroblast growth factor 21 (FGF-21) as an important metabolic regulator, and even biomarker of metabolic changes in obesity and T2DM. Impact of metabolic dysregulation that accompany obesity and T2DM in CAD development remain a great challenge. Aims: To study TGF- and FGF-21 level in patients with obesity and T2DM. Materials and methods: TGF- and FGF-21 were identified in peripheral blood samples of 66 patients with obesity, aged 48-65 years. 1st group included 21 patients with CHD and T2DM; 2nd group (22 patients)- with T2DM and excluded CHD; 3rd group (20 patients) with normal glucose metabolism and excluded CHD. Results: TGF- was lower in patients with CHD (group 1) than in the group of "metabolically healthy" obesity (p=0.022). TGF- in patients with T2DM negatively correlated with LDL cholesterol (r=-0.426, p=0.038) the degree of internal carotid artery stenosis (r=-0.426, p=0.024). Patients with verified CHD had a negative correlation with the processes of heart muscle remodeling (thickness of the left ventricular posterior wall (r=- 0.386, p=0.029) interventricular septum (r=-0.335, p=0.031). All patients with obesity had significantly increased level of FGF-21 compared with the control group (p=0.031) FGF-21 positively correlated with BMI (r=0.473, p=0.033) Conclusions: TGF- has negative correlations with the factors that can influence prognosis and the severity of the CVD/. There were found correlations of FGF-21, TGF- with pathological angiogenesis and changes in normal cardiac geometry in obesity, T2DM and CAD.

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