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 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 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 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

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

scholarly journals Chronic heart failure in patients with type 2 diabetes mellitus: prevalence, prognosis

2015 ◽  
Vol 6 (1) ◽  
pp. 16-23
Author(s):  
S. V Kakorin ◽  
I. A Averkova ◽  
A. M Mkrtumyan
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure ◽  
Carbohydrate Metabolism ◽  
The Status ◽  
Treatment Prognosis

The article presents a literature review of prevalence, prognosis and treatment of overt tactics of chronic heart failure (CHF) in patients with type 2 diabetes mellitus (T2DM). Diabetes and heart failure acquire the status of the epidemic of the XXI century and require health care costs for prevention and treatment of these diseases. Application of modern pharmacological preparations and instrumental treatment of cardiovascular disease (CVD) increases life expectancy and improves the quality of life of patients with CHF as with normal carbohydrate metabolism (UO), and with type 2 diabetes. However, the risk of cardiovascular mortality (CAS) in patients with type 2 diabetes, compared to having a normal carbohydrate metabolism remains unchanged. The rapidly growing population of patients with type 2 diabetes will soon change this in recent years to improve representation treatment prognosis of cardiovascular disease. Violation of myocardial remodeling in type 2 diabetes is caused by a combination of factors associated with diabetic cardiomyopathy. Reduction of the metabolic activity of cardiomyocytes insufficient glucose transport into cells, endothelial dysfunction, diabetic macro and microangiopathy myocardial fibrosis leading to disruption of filling the left ventricle (LV) and the development of chronic heart failure.Insulin resistance (IR) and compensatory hyperinsulinemia (GI) play a key role in the pathogenesis of type 2 diabetes. With effective treatment of chronic heart failure by cardiologists in patients with type 2 diabetes, affecting therapy with insulin resistance should be mandatory.

scholarly journals Correction to: Management of patients with chronic heart failure and type 2 diabetes mellitus: the SCODIAC-II study

2021 ◽  
Author(s):  
Mariarosaria De Luca ◽  
Giorgio Bosso ◽  
Antonio Valvano ◽  
Vincenzo Guardasole ◽  
Amodio Botta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Heart Failure
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