The relationship of diurnal variability and level of glycemia with structural and functional parameters of heart in patients with chronic heart failure and diabetes mellitus type 2
DOI:
https://doi.org/10.15587/2313-8416.2016.59329Keywords:
chronic heart failure, diabetes mellitus, systolic and diastolic heart functions, glycemia profile variabilityAbstract
An important contribution in the development of diabetes mellitus (DM) complications makes not only the chronic hyperglycemia but also the intense diurnal glycemia variability (GV). The aim of research was to assess systolic and diastolic heart functions in patients with chronic heart failure (CHF) of ischemic genesis on the background of DM type 2 depending on GV profile and the mean level of glycemia during the last 3 month.
Methods: There were examined 65 patients who were divided into groups twice on the different categoric indicators. The first indicator – an intensity of glycemia profile (GP) variability, the second – the mean calculated level of glucose concentration in patients during the last 3 month. All patients underwent dopplerechocardiography, the standard declination and the coefficient of GP variations were calculated. An assessment of reliability of the results of statistic study was carried out by nonparametric method.
Results: in patients with the high GP variability was detected the reliably greater size of the left atrium, decrease of the left ventricle output fraction, tendency to the transition of diastolic dysfunction from the I type to the II one comparing with the group with low GP variability. There was not revealed any reliable difference between groups or correlative connection of the mean level of glycemia with parameters that characterize contractility and diastolic myocardium function.
Conclusions: There was revealed the negative influence of the high glycemia variability on systolic and diastolic heart functions, left atrium size and there was not revealed any reliable influence of the mean level of glycemia on cardiohemodynamics
References
Kornatsky, V. M. (2013). Problema bolezney sistemy krovoobrashcheniya i puti eye minimizatsii v Ukraine [The problem of cardiovascular diseases and ways to minimize them in Ukraine]. Kardiologiya, 5, 10–13.
Ettinger, O. A. (2012). Khronicheskaya serdechnaya nedostatochnost u bolnykh sakharnym diabetom: sovremennye predstavleniya [Chronic heart failure in patients with diabetes: current understanding]. Farmateka, 16, 80–85.
Shimizu, T., Yoshihisa, A., Kanno, Y., Takiguchi, M., Sato, A., Miura, S. et. al (2015). Relationship of hyperuricemia with mortality in heart failure patients with preserved ejection fraction. American Journal of Physiology – Heart and Circulatory Physiology, 309 (7), H1123–H1129. doi: 10.1152/ajpheart.00533.2015
Klimontov, V. V., Myakina, N. E. (2014). Variabelnost glikemii pri sakharnom diabete: instrument dlya otsenki kachestva glikemicheskogo kontrolya i riska oslozhneny [Glycaemic variability in diabetes: a tool for assessing the quality of glycaemic control and the risk of complications]. Sakharny diabet, 2, 76–82.
Vijan, S., Sussman, J. B., Yudkin, J. S., Hayward, R. A. (2014). Effect of Patients’ Risks and Preferences on Health Gains With Plasma Glucose Level Lowering in Type 2 Diabetes Mellitus. JAMA Internal Medicine, 174 (8), 1227. doi: 10.1001/jamainternmed.2014.2894
Currie, C. J., Peters, J. R., Tynan, A., Evans, M., Heine, R. J., Bracco, O. L. et. al (2010). Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study. The Lancet, 375 (9713), 481–489. doi: 10.1016/s0140-6736(09)61969-3
Krinsley, J. S. (2008). Glycemic variability: A strong independent predictor of mortality in critically ill patients*. Critical Care Medicine, 36 (11), 3008–3013. doi: 10.1097/ccm.0b013e31818b38d2
Nazhmutdinova, P. K. (2014). Nepreryvnoye monitorirovaniye glikemii pri sakharnom diabete 2-go tipa [The continuous monitoring of glucose in diabetes mellitus type 2]. Available at: http://www.remedium.ru/doctor/endocrinology/detail.php?ID=61929
Natsionalnye rekomendatsii OSSN, RKO i RNMOT po diagnostike i lecheniyu KhSN (chetverty peresmotr) [National guidelines PRAs, RKO and RNMOT for diagnosis and treatment of chronic heart failure (fourth revision)] (2013). Zhurnal Serdechnaya Nedostatochnost, 14/7 (81), 379–472. Available at: http://www.scardio.ru/content/Guidelines/SSHF-Guidelines-rev.4.0.1.pdf
Classification and Diagnosis of Diabetes (2014). Diabetes Care, 38, S8–S16. doi: 10.2337/dc15-s005
Lang, R. M., Biering, M., Devereux, R. B. (2012). Rekomendatsii po kolichestvennoy otsenke struktury i funktsii kamer serdtsa [Guidelines for quantification of the structure and function of the heart chambers]. Rossysky kardiologichesky zhurnal, 3 (95), 1–28.
Downloads
Published
Issue
Section
License
Copyright (c) 2016 Наталья Игоревна Капшитарь, Виктор Денисович Сыволап
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
