scholarly journals Clinical significance of the determination of natriuretic peptides in diastolic dysfunction of the left ventricle in patients with type 2 diabetes mellitus

2021 ◽  
Vol 2 (3) ◽  
pp. 56-61
Author(s):  
E. S. Krutikov ◽  
V. A. Tsvetkov ◽  
S. I. Chistyakova ◽  
R. O. Akaev

Objective: of article was to study the level of cerebral natriuretic peptide in patients with type 2 diabetes mellitus with diastolic dysfunction and with various types of left ventricular remodeling. Materials and methods: 256 patients with type 2 diabetes mellitus (DM) who had moderate arterial hypertension (AH) and no clinical signs of chronic heart failure were examined. The control group consisted of 30 practically healthy persons, comparable in age and sex with the examined patients. All patients were determined the concentration of brain natriuretic peptide (BNP) in blood plasma. The structural and functional parameters of the heart were determined by echocardiography in B- and M-modes according to the standard technique. Results: in patients with type 2 diabetes and diastolic dysfunction, the BNP concentration was 156 (84; 228) pg / ml, in patients without diastolic filling disorders — 24 (12; 38) pg / ml. The highest BNP values were found in the subgroup of patients with a restrictive type of transmitral flow. Also, BNP values were higher in the group of patients with concentric and eccentric left ventricular (LV) hypertrophy. Conclusion: in all patients with type 2 diabetes and concomitant moderate hypertension, even in the absence of clinical signs of CHF, there is an increase in the BNP level compared to the control group. The highest BNP values were observed in patients with severe diastolic dysfunction and unfavorable variants of LV remodeling.

Author(s):  
Swapnil Jain ◽  
C. L. Nawal ◽  
Amandeep Singh ◽  
Radhey Shyam Chejara ◽  
Sagar Barasara ◽  
...  

Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (<5yr) Type 2 Diabetes Mellitus by Echocardiography and also to determine association of glycemic status (by HBA1c levels) with left ventricular diastolic dysfunction (LVDD).Methods: An observational descriptive study involving 100 diabetic patients, taken on first come first serve basis after applying inclusion and exclusion criteria. In all the subjects, other than routine investigations, HbA1c was estimated and echocardiography was done to evaluate LVDD.Results: Mean value of HbA1c in the study was 8.31+ 1.408 %. 63 out of 100 subjects had LVDD. There was significant positive correlation between HbA1c and LVDD (p value <0.001). As HbA1c increased, severity of LVDD increased. In this study, as BMI increased, HbA1c and LVDD increased & both findings were statistically significant (p value =0.001).Conclusion: Our study indicates that myocardial damage in patients with diabetes affects diastolic function before systolic function &higher HbA1C level is strongly associated with presence of LVDD. Patients should be advised strict control of diabetes in order to reduce the risk for developing LVDD which is a precursor for more advanced disease.Keywords: Diabetes mellitus, Diastolic dysfunction, BMI, HbA1c


HYPERTENSION ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 5-10
Author(s):  
I.I. Topchiy ◽  
O.N. Kirienko ◽  
P.S. Semyonovykh ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  

Currently, diabetes mellitus (DM) is a complex global problem, which is increasing every year. So, in 2019, diabetes mellitus was detected in 463 million adults (from 20 to 79 years old) in the world. And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The study was aimed investigate the features of functional and structural changes in the heart in patients with type 2 diabetes mellitus and nephropathy. A total of 98 patients with type 2 diabetes mellitus were examined, out of which 78 patients had diabetic nephropathy (DN) of varying severity. The control group consisted of 20 healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I — patients with type 2 diabetes mellitus without signs of nephropathy (n = 36), group II — patients with type 2 diabetes mellitus with normal glomerular filtration rate (GFR) and albuminuria (n = 33), group III — patients with type 2 diabetes mellitus with decreased GFR and albuminuria (n = 29). To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique based on the recommendations of the American Echocardiographic Society. To determine indexing indicators, the patients underwent anthropometric measurements. Patients with DN and albuminuria and decreased GFR showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With DN, patients have a significant increase in left ventricular mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100 % with a decrease in GFR.


2015 ◽  
Vol 61 (2) ◽  
pp. 21-27
Author(s):  
I P Tatarchenko ◽  
N V Pozdnyakova ◽  
A G Denisova ◽  
O I Morozova

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.


2021 ◽  
Vol 90 (1) ◽  
pp. 44-51
Author(s):  
I.I. Topchii ◽  
P.S. Semenovykh ◽  
O.M. Kirienko ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  

Currently, diabetes mellitus is a complex global problem, which is increasing every year. So in 2019, diabetes in the world was detected in 463 million adults (from 20 to 79 years old). And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The features of functional and structural changes in the heart were studied in patients with type 2 diabetes mellitus and nephropathy. A total of 75 patients with type 2 diabetes mellitus were examined, of which 50 patients had diabetic nephropathy of varying severity. The control group consisted of 20 healthy individuals. The control group consisted of 20 practically healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I consisted of 25 patients with type 2 diabetes mellitus without signs of nephropathy; group II consisted of 26 patients with type 2 diabetes mellitus with normal glomerular filtration rate and albuminuria; group III consisted of 24 patients with type 2 diabetes mellitus with decreased glomerular filtration rate and albuminuria. To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique according to the recommendations of the American Echocardiographic Society. Indicators the patients underwent anthropometric measurements. Patients with diabetic nephropathy and albuminuria and decreased glomerular filtration rate showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With diabetic nephropathy patients have a significant increase in left ventricular myocardial mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100.0 % with a decrease in glomerular filtration rate. Keywords: diabetes mellitus, hypertonic disease, diabetic nephropathy, heart remodeling, chronic kidney disease.


Author(s):  
Zengfa Huang ◽  
Jianwei Xiao ◽  
Zuoqin Li ◽  
Yun Hu ◽  
Yuanliang Xie ◽  
...  

Background: Left ventricular diastolic dysfunction (LVDD) is a common abnormality among patients in T2DM. Aim: We aimed to evaluate the feasibility of coronary computed tomography angiography (CCTA) for the assessment of LVDD in type 2 diabetes mellitus (T2DM) patients. Methods: 80 consecutive T2DM patients who were referred for a clinically dual-source CCTA examination to evaluate suspected coronary artery disease and also underwent 2D echocardiography within 7 days of CCTA inclusion and exclusion criteria, were performed. Correlation between CCTA and echocardiography was tested through linear regression and Bland-Altman analysis. Results: In total, 60 T2DM patients were included for the analysis. Pearson correlation showed good correlation for E (r = 0.28; P = 0.028), E/A (r = 0.69; P < 0.01); E (r = -0.06; P = 0.776), E/A (r = 0.54; P = 0.003) and E (r = 0.64; P < 0.01), E/A (r = 0.83; P < 0.01) in three groups, respectively. Overall, diagnostic accuracy for assessment in CCTA of diastolic dysfunction was 79.76% (95% CI: 68%-91%), 71.43% (95% CI: 58%-85%) and 87.50 (95% CI: 79%-96%) in three groups. Conclusion: The presented study proved that CCTA showed good correlations in the estimation of LV filling pressures compared with echocardiography in T2DM patients. Accordingly, retrospectively ECG-gated CCTA may provide valuable information on the evaluation of LVDD in T2DM patients.


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