scholarly journals Complete left bundle branch block as predictor of cardiogenic shock in patient with acute myocardial infarction on the background of diabetes mellitus type 2

2020 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Left Bundle Branch Block ◽  
Diabetes Mellitus Type 2 ◽  
Diabetes Mellitus Type ◽  
Bundle Branch Block

Cardiogenic shock is the leading cause of death in patients with acute myocardial infarction, with high hospital mortality rates ∼80 %. The incidence of cardiogenic shock among myocardial infarction patients is approximately 7 %. Cardiogenic shock patients are found that pre-existing diabetes is associated with an increased risk of cardiogenic shock and it worsens outcomes, with a longer hospital stay. Cardiogenic shock develops approximately twice as often among diabetics as among nondiabetic patients with acute myocardial infarction. Diabetes mellitus and left bundle branch block are predictors of cardiogenic shock complicating acute myocardial infarction. Except for bad prognosis, left bundle branch block can be a marker of a slowly progressing, degenerative, ischemic or non-ischemic cardiac disease, affecting not only the muscle but also the heart conduction system. Immediate diagnosis and management are required. In this article, a clinical case of acute posterior myocardial infarction complicated by complete left bundle branch block and cardiogenic shock in the patient with concomitant diabetes mellitus type 2 is demonstrated. This article emphasizes the priority of referring patients with left bundle branch block to primary percutaneous coronary intervention, usage of more specific ECG criteria for acute coronary syndrome, the role of myocardial infarction biomarker including sensitive assays for cardiac troponins, and bedside echocardiography which may improve diagnostic accuracy and result in timely intervention in such patients. This article also underlines the role of mechanical circulatory support, urgent reperfusion therapy, and strict control of glycemia in the acute phase of myocardial infarction which may contribute to clinical stability of patients with diabetes mellitus and myocardial infarction complicated by cardiogenic shock.

scholarly journals THE RELATIONSHIP BETWEEN CALPROTECTIN AND PARAMETERS OF LIPID AND CARBOHYDRATE METABOLISM, ANTHROPOMETRIC AND INFLAMMATORY PARAMETERS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND DIABETES MELLITUS TYPE 2

2019 ◽  
Vol 19 (2) ◽  
pp. 16-18
Author(s):  
M. I. Zhuravlova
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Insulin Resistance ◽  
Acute Myocardial Infarction ◽  
Carbohydrate Metabolism ◽  
Diabetes Mellitus Type 2 ◽  
The Body ◽  
Diabetes Mellitus Type ◽  
The Relationship

Nowadays, an acute myocardial infarction is one of the leading causes of mortality among the population. The EHS-DH registry data clearly illustrate the association between the comorbidities and high mortality following acute myocardial infarction during a year period of follow up. The pronounced influence of carbohydrate metabolism disturbances on the survival of such patients has already been reported. The aim of the study was to analyze the immune inflammation relationships based on assessing calprotectin and the parameters of lipid and carbohydrate metabolism, to evaluate the presence and nature of the relationship between these parameters and carbohydrate metabolism parameters based on the study of blood glucose, insulin and insulin resistance (by the indices HOMA, QUICKI, Caro), anthropometric indicators and inflammatory indicators (monocyte and neutrophile levels). Materials and methods. The study included 64 patients (mean age 65, 31 ± 1.62 years) with acute myocardial infarction and concomitant diabetes mellitus type 2. The design of the study included the primary laboratory investigation of patients during the first day since the onset of acute myocardial infarction with the elevation of the ST segment before the initiation of thrombolytic therapy or percutaneous intervention. The direct correlation between the calprotectin concentration and the HOMA insulin resistance index (R = 0.52; p <0.05), insulinemia (R = 0.57; p <0.05), fasting glycaemia (R = 0, 59; p <0.05), as well as inverse correlation relationships between the Caro index (R = 0.68; p <0.05) and the QUICKI index (R = 0.59; p <0.05) were found out. Moreover, a direct correlation between calprotectin and triglyceride levels (R = 0.31; p <0.05), and negative correlation with high density lipoprotein (R = 0.35; p <0.05) was established as well. The level of total cholesterol and low density lipoproteins showed no significant association with the proinflammatory factor (R = 0.12; p> 0.05 and R = 0.18; p> 0.05, respectively). Conclusions. The increase in the body mass index and the activity of serum monocytes and neutrophils is associated with high concentrations of calprotectin that is accompanied by disturbances of carbohydrate homeostasis towards the growth of insulin resistance and changes of lipidograms of proatherrogenic nature.

scholarly journals Dysmetabolic Syndrome in a Man with a Novel Mutation of the Aromatase Gene: Effects of Testosterone, Alendronate, and Estradiol Treatment

2004 ◽  
Vol 89 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Laura Maffei ◽  
Yoko Murata ◽  
Vincenzo Rochira ◽  
Gloria Tubert ◽  
Claudio Aranda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Diabetes Mellitus Type 2 ◽  
Acanthosis Nigricans ◽  
Diabetes Mellitus Type ◽  
Bone Maturation ◽  
Bilateral Cryptorchidism ◽  
High Doses

We present the fourth case of an adult man (29 yr old) affected by aromatase deficiency resulting from a novel homozygous inactivating mutation of the CYP19 (P450arom) gene. At first observation, continuing linear growth, eunuchoid body proportions, diffuse bone pain, and bilateral cryptorchidism were observed. The patient presented also a complex dysmetabolic syndrome characterized by insulin resistance, diabetes mellitus type 2, acanthosis nigricans, liver steatohepatitis, and signs of precocious atherogenesis. The analysis of the effects induced by the successive treatment with high doses of testosterone, alendronate, and estradiol allows further insight into the roles of androgens and estrogens on several metabolic functions. High doses of testosterone treatment resulted in a severe imbalance in the estradiol to testosterone ratio together with the occurrence of insulin resistance and diabetes mellitus type 2. Estrogen treatment resulted in an improvement of acanthosis nigricans, insulin resistance, and liver steatohepatitis, coupled with a better glycemic control and the disappearance of two carotid plaques. Furthermore, the study confirms previous data concerning the key role of estrogens on male bone maturation, at least in part, and regulation of gonadotropin secretion. The biopsy of the testis showed a pattern of total germ cell depletion that might be due to the concomitant presence of bilateral cryptorchidism. Thus, a possible role of estrogen in male reproductive function is suggested but without revealing a direct cause-effect relationship. Data from this case provide new insights into the role of estrogens in glucose, lipid, and liver metabolism in men. This new case of aromatase deficiency confirms previous data on bone maturation and mineralization, and it reveals a high risk for the precocious development of cardiovascular disease in young aromatase-deficient men.

scholarly journals Role of ACE and AGT gene polymorphisms in genetic susceptibility to diabetes mellitus type 2 in a Brazilian sample

2015 ◽  
Vol 14 (4) ◽  
pp. 19110-19116 ◽  
Author(s):  
L.M. Wollinger ◽  
S.M. Dal Bosco ◽  
C. Rempel ◽  
S.E.M. Almeida ◽  
D.B. Berlese ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Genetic Susceptibility ◽  
Gene Polymorphisms ◽  
Diabetes Mellitus Type 2 ◽  
Diabetes Mellitus Type ◽  
Brazilian Sample ◽  
Agt Gene
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