Molecular biomarker profile of heart failure with mid-range and preserved ejection fraction in patients with type 2 diabetes

Лебедев, Д. А.; Лясникова, Е. А.; Васильева, А. А.; Васильева, Е. Ю.; Бабенко, А. Ю.; Шляхто, Е. В.

doi:10.15829/1560-4071-2020-3967

Cited by 7 publications

(2 citation statements)

References 31 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Известно, что наряду с АГ, и ожирение, и СД2 ассоциированы с увеличением массы миокарда [15] и наиболее часто предрасполагают к развитию концентрических вариантов ремоделирования ЛЖ, что отмечалось в других наших исследованиях пациентов с преимущественно по этиологической детерминанте "метаболическим" клиническим фенотипом СНсФВ и СНпФВ, имеющих ожирение и СД2, и лишь в половине случаев ИБС и перенесенный ИМ в анамнезе [19,20]. В настоящей работе обсуждаются пациенты с ПИКС, имеющие СНпФВ, у которых в большинстве случаев встречалось увеличение показателей ММЛЖ в сочетании с дилатацией полости ЛЖ.…”

Section: Discussionunclassified

Impact of obesity on echocardiographic parameters and N-terminal pro-brain natriuretic peptide levels in patients with heart failure with mid-range ejection fraction: unanswered questions

et al. 2021

Self Cite

View full text Add to dashboard Cite

Aim. To analyze and compare the clinical, echocardiographic characteristics and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels depending on the central cardiometabolic risk factors, with a focus on obesity, in patients with heart failure (HF) with mid-range ejection fraction (HFmrEF).Material and methods. The study included 111 patients with old myocardial infarction and HFmrEF (men, 100%; mean age, 60 years) predominantly of NYHA class II. Echocardiography and blood sampling for NT-proBNP were performed with sinus rhythm. Left atrial volume (LAV) and left ventricular mass (LVM) were indexed to body surface area (BSA) and height raised to a power.Results. Type 2 diabetes, overweight and obesity were diagnosed in 25%, 19%, 38% of cases, respectively, and were associated with greater changes in the morphologic and functional left ventricular parameters. There were no intergroup differences among patients with and without obesity in the LAV and LVM indexed to BSA. However, in patients with a body mass index (BMI) ≥30 kg/m2, the LAV indexed to height squared and LVM indexed to height2,7 were higher (p<0,05 for all). In 11% of obese patients, there were no changes in the criterion LAV or LVM values indexed to BSA, but the values indexed to height raised to a power exceeded the standard values. In 20% of patients with clinical manifestations of stable HFmrEF and structural and functional echocardiographic criteria, NT-proBNP were ≤125 pg/ml. An inverse correlation was found between NT-proBNP and BMI (r=-0,29; p=0,008), and lower values of myocardial stress marker were observed in obese patients (p=0,048).Conclusion. Considering the high incidence of obesity in patients with HFmrEF and its ability to reduce NT-proBNP, an algorithm modification is required for diagnosing HFmrEF as follows: focus on clinical and personalized echocardiography data, taking into account the obesity and, possibly, indexing the threshold natriuretic peptide values in patients with BMI ≥30 kg/m2. The issues of indexation of echocardiographic parameters depending on morphometric parameters in obese patients today remain open, predetermining the limitations in diagnosis of heart failure with left ventricular ejection fraction >40%. This requires the search for optimal standardization and the development of a unified methodological approach.

show abstract

Section: Discussionunclassified

Impact of obesity on echocardiographic parameters and N-terminal pro-brain natriuretic peptide levels in patients with heart failure with mid-range ejection fraction: unanswered questions

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…По данным исследований последних лет, у лиц с ХСНунФВ повышены значения объемных показателей ЛЖ и ИММ ЛЖ, а СД и инсулинорезистентность ассоциированы с увеличением ММ ЛЖ и ОТС ЛЖ и предрасполагают к развитию концентрических вариантов ремоделирования ЛЖ [14]. В результате нашего исследования у всех пациентов выявлено ремоделирование ЛЖ с достоверным увеличением КДО ЛЖ, КСО ЛЖ, ИММ ЛЖ, ИОЛП по сравнению с контрольной группой, а также достоверное повышение этих показателей в 1-й группе пациентов по сравнению со 2-й.…”

Section: таблица 2 содержание биомаркеров в сыворотке крови пациентов...unclassified

Relationship of Aldosterone, Tissue Inhibitor of Matrix Metalloproteinase-1 and Tumor Necrosis Factor-Alpha with Myocardial Remodeling in Patients with Chronic Heart Failure and Diabetes Mellitus

Ефремова¹,

Васильева²,

Гостева³

2022

Кардиология В Беларуси

View full text Add to dashboard Cite

Цель. Изучить связь альдостерона (АЛ), тканевого ингибитора матриксных металлопротеиназ-1 (ТИМП-1) и фактора некроза опухоли-альфа (ФНО-α) с ремоделированием миокарда у пациентов с хронической сердечной недостаточностью с умеренно сниженной фракцией выброса (ХСНунФВ) и сахарным диабетом (СД). Материалы и методы. Обследовано 76 пациентов, 40 мужчин (52,6%) и 36 женщин (47,4%), от 46 до 73 лет с диагнозом СД и ХСНунФВ (ФВ 41–49%), с I и II функциональным классом ХСН по NYHA. Контрольную группу составили 16 человек. Пациентам проведены ЭхоКГ, определение сывороточных уровней АЛ, ТИМП-1и ФНО-α методом ИФА. Пациенты разделены на 2 группы: 1-я – лица с ХСНунФВ и СД, перенесшие инфаркт миокарда (ИМ), – 37 человек (48,7%); 2-я – пациенты с ХСНунФВ и СД – 39 человек (51,3%). Для статистического анализа использовалась программа Statisticа 10.0. Различия считались статистически значимыми при уровне р<0,05. Результаты. Выявлено значимое повышение объемных и индексных показателей левого желудочка (ЛЖ) и левого предсердия (ЛП) у пациентов 1-й группы по сравнению со 2-й: КДО ЛЖ на 15,2%, КСО ЛЖ на 13,5%, ОЛП на 14,6%, ИММ ЛЖ на 19,8%, ИОЛП на 16,1% (р<0,05). Установлено ремоделирование миокарда: концентрическая гипертрофия – в 1-й группе 13,5%, во 2-й группе 56,4%; концентрическое ремоделирование ЛЖ – в 1-й группе 21,6%, во 2-й группе 38,5%; эксцентрическая гипертрофия – в 1-й группе 64,9%, во 2-й группе 5,1%. Сывороточные уровни АЛ, ТИМП-1 и ФНО-α пациентов 1-й группы превышали таковые пациентов 2-й группы: АЛ – в 1,6 раза, ТИМП-1 – в 1,9 раза, ФНО-α – в 2,4 раза (р<0,05). Выводы. У пациентов с СД и ХСНунФВ, перенесших ИМ, преобладает эксцентрический тип ремоделирования ЛЖ, а значения объемных и индексных показателей ЛЖ и ЛП выше по сравнению с пациентами с СД и ХСНунФВ, у которых, кроме того, преобладают концентрические типы ремоделирования ЛЖ. Лица с СД и ХСНунФВ, перенесшие ИМ, имеют и более высокие сывороточные уровни АЛ, ТИМП-1 и ФНО-α, поэтому динамика этих биомаркеров может быть использована для диагностики прогрессирования ХСНунФВ у пациентов с СД. Purpose. To study the relationship of aldosterone (AL), TIMP-1 and TNF-α with myocardial remodeling in patients with chronic heart failure with moderately reduced ejection fraction (HFmrEF) and diabetes mellitus (DM). Materials and methods. A total of 76 patients were examined, including 40 men (52.6%) and 36 women (47.4%), aged between 46 and 73 years and diagnosed with DM and HFmrEF (EF=41–49%), and with NYHA functional class I and II HF. The control group consisted of 16 subjects. Patients underwent ECHO-KG, determination of serum levels of AL, TIMP-1 and TNF-α by ELISA. Patients were divided into 2 groups: group 1 – patients with HFmrEF and DM after myocardial infarction (MI), 37 subjects (48.7%), group 2 – patients with HFmrEF and DM, 39 subjects (51.3%). For statistical analysis the software Statistica 10.0 was used. Differences were considered statistically significant at p<0.05. Results. A significant increase in volumetric and index parameters of the left ventricle (LV) and left atrium (LA) was revealed in group 1 patients compared with group 2: LV EDV by 15.2%, LV ESV by 13.5%, VLP by 14,6%, LVMI by 19.8%, and LAVI by 16.1% (p<0.05). Myocardial remodeling was revealed: concentric hypertrophy – 13.5% in group 1, and 56.4% in group 2; concentric LV remodeling – 21.6% in group 1, and 38.5% in group 2; eccentric hypertrophy – 64.9% in group 1, and 5.1% in group 2. Serum levels of AL, TIMP-1 and TNF-α in group 1 patients exceeded those in group 2: AL by 1.6 times, TIMP-1 by 1.9 times, and TNF-α by 2.4 times (p<0.05). Conclusions. In patients with diabetes and chronic heart failure who underwent myocardial infarction, the eccentric type of LV remodeling was prevalent, whereas the values of volumetric and index parameters of the left ventricle and left ventricle are higher if compared to patients with diabetes and chronic heart failure, in whom, moreover, concentric types of LV remodeling were prevalent. Patients with diabetes and chronic heart failure who underwent MI also had higher serum levels of AL, TIMP-1 and TNF-α, so the dynamics of these biomarkers could be used to diagnose the progression of chronic heart failure in patients with diabetes.

show abstract

Factors associated with long-term adverse cardiovascular events in patients with type 2 diabetes

2021

View full text Add to dashboard Cite

Aim. To identify factors associated with long-term adverse cardiovascular events (CVEs) in patients with type 2 diabetes (T2D).Material and methods. The study included 94 T2D patients aged 40 to 65 years with or without early symptoms of heart failure (HF). Patients underwent clinical and laboratory investigations, 6-minute walk test (6MWT), and echocardiography. Concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) was determined. After 8,8±0,72 years of follow-up, the prevalence of following CVEs among patients were assessed: any-cause death, myocardial infarction, stroke, emergency myocardial revascularization, hospitalization due to decompensated HF. We assessed the relationship between the development of long-term CVEs in T2D patients and the initial characteristics using logistic regression model.Results. Over a period of 8,8±0,72 years, CVEs occurred in 34 out of 88 (38,6%) patients with T2D. The baseline 6MWT values were lower in patients with CVEs (391,8±56,2 m vs 418,8±53,9 m, p=0,04). Stable coronary artery disease (55,9% vs 27,8%, p=0,008), early-stage HF (61,8% vs 27,8%; p=0,0016) were more common among patients with CVEs. Patients with CVEs had higher median initial NT-proBNP (46,9 pg/ml vs 24,2 pg/ml, p=0,01) and mean left atrial (LA) size (4,5±0,6 cm vs 4,19±0,5 cm, p=0,04) levels. The logistic regression established following factors associated with long-term CVEs in patients with T2D: NT-proBNP level (p=0,05), LA size (p=0,01), and 6MWT results (p=0,002).Conclusion. The development of long-term CVEs in middle-aged T2D patients with or without early-stage HF is associated with an initially increased NT-proBNP levels, an increase in left atrial size, and a decrease in 6MWT values. Further prospective studies with larger samples are needed to identify other factors affecting outcome in patients with early signs of HF.

show abstract

Molecular biomarker profile of heart failure with mid-range and preserved ejection fraction in patients with type 2 diabetes

Cited by 7 publications

References 31 publications

Impact of obesity on echocardiographic parameters and N-terminal pro-brain natriuretic peptide levels in patients with heart failure with mid-range ejection fraction: unanswered questions

Impact of obesity on echocardiographic parameters and N-terminal pro-brain natriuretic peptide levels in patients with heart failure with mid-range ejection fraction: unanswered questions

Relationship of Aldosterone, Tissue Inhibitor of Matrix Metalloproteinase-1 and Tumor Necrosis Factor-Alpha with Myocardial Remodeling in Patients with Chronic Heart Failure and Diabetes Mellitus

Factors associated with long-term adverse cardiovascular events in patients with type 2 diabetes

Contact Info

Product

Resources

About