THE ESTIMATION OF THE SOMATIC SIGNIFICANCE OF HYPERVENTILATION SYNDROME IN THE STUDIED WITH DIFFERENTIATED CARDIOLOGICAL STATUS

Author(s):  
Никита Игоревич Воронин ◽  
Дмитрий Сергеевич Кузнецов

В статье представлены данные оригинального исследования по оценке фактической частоты встречаемости и значимости в формировании тяжести соматического состояния организма у трех групп обследуемых с различным кардиологическим статусом - условно здоровых лиц молодого возраста, пациентов пожилого возраста с хронической сердечной недостаточностью и пациентов с нестабильной стенокардией, протекающей на фоне сахарного диабета второго типа. Установлено, что во всех трех группах фактическая встречаемость гипервентиляционного синдрома является выше таковой, чем это считалось ранее на уровне традиционных представлений. Помимо этого, его присутствие имеет соматическую значимость для обследуемых с любым кардиологическим статусом, причем она возрастает по мере увеличения тяжести вовлечения в патологический процесс сердечно-сосудистой системы. Для условно здоровых лиц молодого возраста он вызывает субклинические негативные последствия, для пациентов с хронической сердечной недостаточностью - умеренные клинически значимые негативные последствия, для пациентов с нестабильной стенокардией на фоне сахарного диабета второго типа - выраженные клинические негативные последствия в виде ухудшения течения и исходов заболевания. Полученные результаты отличает новизна и практическая значимость, что позволяет рекомендовать их к дальнейшему учету в практике специалистов клиники внутренних болезней The article presents data from an original study to assess the actual frequency of occurrence and significance in the formation of the severity of the somatic state of the body in three groups of subjects with different cardiac status - conventionally healthy young people, elderly patients with chronic heart failure and patients with unstable angina pectoris occurring against the background of type 2 diabetes mellitus. It was found that in all three groups the actual incidence of hyperventilation syndrome is higher than it was previously thought at the level of traditional ideas. In addition, its presence has somatic significance for subjects with any cardiac status, and it increases as the severity of involvement in the pathological process of the cardiovascular system increases. For conventionally healthy young people, it causes subclinical negative consequences, for patients with chronic heart failure - moderate clinically significant negative consequences, for patients with unstable angina pectoris associated with type 2 diabetes mellitus - pronounced clinical negative consequences in the form of worsening of the course and outcomes of the disease. The results obtained are distinguished by their novelty and practical significance, which makes it possible to recommend them for further consideration in the practice of specialists in the clinic of internal diseases

Medicine ◽  
2020 ◽  
Vol 99 (30) ◽  
pp. e21091
Author(s):  
Hui Wang ◽  
Jun Zhang ◽  
Chun-fang Shi ◽  
Jing Jia ◽  
Zhi-min Zhang ◽  
...  

2007 ◽  
Vol 143 (2) ◽  
pp. 207-209 ◽  
Author(s):  
N. E. Arzamastseva ◽  
V. Z. Lankin ◽  
G. G. Konovalova ◽  
A. K. Tikhaze ◽  
F. T. Ageev ◽  
...  

2015 ◽  
Vol 65 (10) ◽  
pp. A886 ◽  
Author(s):  
Chim C. Lang ◽  
Daniel Levin ◽  
Mohapradeep Mohan ◽  
Helen Parry ◽  
Douglas Elder ◽  
...  

2015 ◽  
Vol 6 (1) ◽  
pp. 16-23
Author(s):  
S. V Kakorin ◽  
I. A Averkova ◽  
A. M Mkrtumyan

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.


Author(s):  
Mariarosaria De Luca ◽  
Giorgio Bosso ◽  
Antonio Valvano ◽  
Vincenzo Guardasole ◽  
Amodio Botta ◽  
...  

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 146-152
Author(s):  
O. V. Tsygankova ◽  
V. V. Veretyuk ◽  
V. Yu. Mareev

Chronic heart failure (CHF) and type 2 diabetes mellitus (DM2) and very common comorbidities with bidirectional, mutually aggravating courses. DM2 is known as an independent risk factor of cardiovascular complications whereas a higher CHF functional class is associated with increased risk of DM2. At present time, hypoglycemic drugs of the gliflozin class and the angiotensin receptor-neprilysin inhibitor (ARNI) are widely discussed in connection with their use in the treatment of patients with CHF and DM. The PARADIGM-HF study investigated effects of long-term treatment of CHF with reduced ejection fraction with presently the only representative of the ARNI class, a single supramolecular complex of valsartan-sacubitril. This medicine has already exceled enalapril at the effect not only on the incidence of nonfatal and fatal cardiovascular events but also on general mortality. Mean age of patients included into that study was 63.8±11.5 years; 21 % of them were females. In real-life clinical practice, physicians more frequently see older patients, and most of them are females, particularly with DM2. On the other hand, sodium-glucose cotransporter-2 inhibitors, including empagliflozin, significantly decreased the death rate and the frequency of CHF exacerbations in patients with DM2 and concomitant cardiovascular diseases, including CHF. This article describes a clinical case of initiating the valsartan-sacubitril treatment in combination with empagliflozin in an elderly female patient with congestive CHF with intermediate ejection fraction (EF) and comorbidities, including a history of myocardial infarction and DM2. Of interest is the rapid positive dynamics of clinical, laboratory (NT-proBNP) and instrumental (echocardiography) markers of CHF. At 3 months, the EF “recovered” from intermediate to preserved during the use of a comprehensive cardio-reno-metabolic approach. Both cardiologists and endocrinologists should definitely consider this approach in managing such patients since current cardiological drugs have additional pleiotropic metabolic effects whereas hypoglycemic drugs, in their turn, influence the cardiological prognosis.


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