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УЖМБС 2020, 5(3): 194–200
https://doi.org/10.26693/jmbs05.03.194
Clinical Medicine

Forming Mechanisms of Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease and Diabetes Mellitus Type 2

Koshkina M. V., Kadykova O.I., Babadzhan V. D., Kravchun P. G., Gridneva O. V.
Abstract

The article defines and evaluates the indicators of diastolic function of the left ventricle in patients with coronary artery disease depending on the presence of type 2 diabetes mellitus by examining 63 patients. Results and discussion. When joining diabetes mellitus type 2 there was an increase of E by 12.1% (р<0.05), A – by 22.1% (р<0.05); E/A decreased by 12% (р<0.05), IVRT – by 3.9%, DT – by 5.6%, that corresponds to diastolic dysfunction of left ventricle by feasibility relaxation type. In patients with coronary artery disease and diabetes mellitus type 2, the strongest correlations were found between HbA1с and E (r = 0.78; г<0.05) and E/A (r = 0.61; р<0.05), the weakest were between HbA1с and A (r = 0.31; р < 0.05). In patients with coronary artery disease and diabetes mellitus type 2, the strongest correlations were found between HbA1с and E (r = 0.78; г<0.05) and E/A (r = 0.61; р<0.05), the weakest correlations were between HbA1с and A (r = 0.31; р < 0.05). Strong correlations were established between TG and E (r = 0.46; р < 0.05); A (r = 0.52; р < 0.05) and E/A (r = 0.49; р < 0.05); between GCS and E (r = 0.51; р < 0.05) and A (r = 0.48; р < 0.05); and between CLPLD CS and E (r = 0.39; р < 0.05) and A (r = 0.41; р < 0.05). Weaker correlations were established between TG and IVRT (r = 0.32; р < 0.05); and GCS level and Е/А (r = 0.35; р < 0.05) and IVRT (r = 0.29; р < 0.05); between LPLD CS and Е/А (r = 0.34; р < 0.05) and DT (r = 0.32; р < 0.05); and between the LPVLD CS and Е (r = 0.28; р < 0.05), А (r = 0.32; р < 0.05), Е/А = (r = 0.28; р < 0.05), IVRT (r = 0.26; р < 0.05), DT = (r = 0.3; р < 0.05). We established weak correlation links between TG and Е (r = 0.27; р < 0.05); and between the LPVLD CS and Е/А (r = 0.25; р < 0.05) in patients with only coronary artery disease. 70.3% of patients with coronary artery disease and diabetes mellitus type 2 had transmitral blood flow by type of pseudo normalization; 21.6% of patients had the restriction type; 5.4% had feasibility relaxation type; 2.7% had normal type. 50% of patients with coronary artery disease only had type of pseudo normalization, 30.7% of patients had feasibility relaxation type, 11.5% had the restriction type, and 7.7% had normal type. Conclusion. The degree of impairment of the diastolic function of left ventricle was more pronounced in patients with coronary artery disease under the condition of attachment of diabetes mellitus type 2, which is likely to be associated with a faster rate of sturdy functional remodeling of left ventricle and associated with metabolic disorders. The type of pseudo normalization and feasibility relaxation were more common in patients with isolated coronary artery disease, while patients with coronary artery disease and diabetes mellitus type 2 had the type of pseudo normalization and restrictive type.

Keywords: coronary artery disease, diabetes mellitus type 2, diastolic dysfunction, type of transmitral blood-flow, carbohydrate metabolism, lipid metabolism

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