Heart remodeling in patients with type 2 diabetes mellitus and arterial hypertension
https://doi.org/10.18705/1607-419X-2012-18-5-435-442
Abstract
Objective. To study features of remodeling of the left ventricle myocardium in patients with arterial hypertension and type 2 diabetes mellitus (DM) in comparison with patients with arterial hypertension and without abnormalities of glucose metabolism. Design and methods. We enrolled 180 patients with degree 1 and 2 arterial hypertension matched by age and gender. They were divided into 2 groups: group 1 included 90 patients with type 2 diabetes mellitus, and group 2 included 90 patients with normal glucose tolerance. Laboratory tests and echocardioscopy were performed. Results. The patients of group 1 had obesity, dyslipidemia and non-compensated type 2 diabetes mellitus. The patients with type 2 diabetes mellitus had concentric left ventricular hypertrophy in comparison with patients with normoglycemia (33 vs. 5,5 %, р < 0,001), including non-obese patients (19 vs. 1,8 %, р = 0,025). Patients with type 2 diabetes mellitus more often had disorders of the left ventricular diastolic function (94,4 vs. 58,9 %, р < 0,000). Disorders of the diastolic function were more obvious in association with type 2 diabetes mellitus with concentric variants of heart remodeling.
About the Authors
I. E. Sapozhnikova
State Budget Educational Institution of Higher Professional Education «Kirov State Medical Academy of the Health Care and Social Development Ministry of Russia»
Russian Federation
Russian Federation
E. I. Tarlovskaya
State Budget Educational Institution of Higher Professional Education «Kirov State Medical Academy of the Health Care and Social Development Ministry of Russia»
Russian Federation
Russian Federation
A. K. Tarlovsky
Kirov Regional Teaching Hospital
Russian Federation
Russian Federation
References
1. Wild S., Roglic G., Green A.R., Sicree R., King H. Global prevalence of diabetes: estimated for the year 2000 and projections for 2030 // Diabetes Care. — 2004. — Vol. 27, № 5. — P. 10471053.
2. Дедов И.И., Шестакова М.В. Сахарный диабет. — М. : Изд-во «Универсум Паблишинг», 2003. — 282 с.
3. Mancia G. The association of hypertension and diabetes: prevalence, cardiovascular risk and protection by blood pressure reduction // Acta Diabetol. — 2005. — Vol. 42, Suppl. 1. — P. S17-S25.
4. Vakili B.A., Okin P.M., Devereux R.B. Prognostic implications of left ventricular hypertrophy // Am. Heart J. — 2001. — Vol. 141, № 3. — P. 334-341.
5. Конради А.О. Лечение артериальной гипертензии в особых группах больных. Гипертрофия левого желудочка // Артериальная гипертензия. — 2001. — Т. 11, № 2. — С. 105-106.
6. Шиллер Н., Осипов М.А. Клиническая эхокардиогра-фия. — М. : «Мир», 1993. — С. 61-80.
7. Ganau A., Devereux R., Roman M. Patterns of left, ventricular hypertrophy and geometric remodeling in essential hypertension // J. Am. Coll. Cardiol. — 1992. — Vol. 19, № 7. — P. 1550-1558.
8. Алгоритмы специализированной медицинской помощи больным сахарным диабетом (5-й выпуск) // Сахарный диабет. — 2011. — Прил., № 3. — C. 6-7
9. Конради А.О., Рудоманов О.Г., Захаров Д.В. и др. Варианты ремоделирования сердца при гипертонической болезни — распространенность и детерминанаты // Терапевт. арх. — 2005. — Т. 9. — С. 8-16.
10. Перетолчина Т.Ф., Дашутина С.Ю., Барац С.С. Ожирение и морфофункциональные изменения сердца // Кардиология. — 2005. — Т. 7. — С. 66-68.
11. Грачев А.В., Аляви А.Л., Ниязова Г.У. и др. Масса миокарда левого желудочка, его функциональное состояние и диастолическая функция сердца у больных артериальной гипертонией при различных эхокардиографических типах геометрии левого желудочка сердца // Кардиология. — 2000. — T. 3. — C. 31-38.
12. Smalcelj A., Puljevic D., Buljeevic B., Brida V. Left ventricular hypertrophy in obese hypertensives: is it really eccentric? (An echocardiographic study) // Coll. Antropol. — 2002. — Vol. 24, № 1. — Р 167-183.
13. Sundstrum J., Lind L., Nystrum N. et al. Left ventricular concentric remodeling rather than left ventricular hypertrophy is related to insulin resistance syndrome in the elderly // Circulation. — 2000. — Vol. 101, № 22. — P. 2595-2600.
14. Devereux R.B., Roman M.J., Paranicas M. et al. Impact of diabetes on cardiac structure and function: the Strong Heart Study // Circulation. — 2000. — Vol. 101, № 19. — P. 2271-2276.
15. Palmeri V., Bella J.N., Arnett D.K. et al. Effect of type 2 diabetes mellitus on left ventricular geometry and systolic function in hypertensive subjects: the HyperGEN Study // Circulation. — 2001. — Vol. 103, № 1. — P. 102-107.
16. Galderisi M. Diastolic dysfunction and diabetic cardiomyopathy // J. Am. Cardiol. — 2006. — Vol. 48, № 8. — P. 1548-1551.
17. Heerebek L., van Paulus W.J. The dialogue between diabetes and diastole // Eur. J. Heart Fail. — 2009. — Vol. 11, № 1. — P. 3-5.
18. Boyer J.K., Thanigraj S., Schechtman K.B. et al. Prevalence of ventricular diastolic dysfuntion in asimptomatic, normotensive patients with diabetes mellitus // Am. J. Cardiol. — 2004. — Vol. 93, № 7. — Р. 870-875.
19. Аметов А.С., Гиляревский С.Р., Дикова Т.Е. и др. Коррекция ранних нарушений функций сердца у больных сахарным диабетом 2 типа // Сердце. — 2008. — Vol. 1. — C. 61-63.
20. Taegtmeyer H., McNulty P., Young M. E. Adaptation and maladaptation of the heart in diabetes: part 1. General concepts // Ciculation. — 2002. — Vol. 105, № 14. — P. 1727-1733.
21. Brownlee M., Cerami A., Vlassara H. Advanced glycosy-lation end products in tissue and the biochemical basis of diabetic complication // N. Engl. J. Med. — 1988. — Vol. 318, № 20. — P. 1315-1321.
Review
For citations:
Sapozhnikova I.E., Tarlovskaya E.I., Tarlovsky A.K. Heart remodeling in patients with type 2 diabetes mellitus and arterial hypertension. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2012;18(5):435-442. (In Russ.) https://doi.org/10.18705/1607-419X-2012-18-5-435-442
Views:
1013
Email this article 