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

Full text: PDF (Ukr) 595K

1. Gonchar AV. Remodelirovanie miokarda i diastolicheskaya disfunktsiya u bolnykh gipertonicheskoy boleznyu s ozhireniem [Myocardial remodeling and diastolic dysfunction in obese hypertensive patients]. Meditsina tretogo tisyacholittya: Zb tez mizhvuz konf molodikh vchenikh ta studentiv, Kharkiv, 15-16 sichnya 2013. Kharkiv; 2013: 79-80. [Russian]
2. Bilovol OM, Shkolnyk VV, Andryeyeva AO. Rol porushennya vuhlevodnoho ta lipidnoho obminiv u formuvanni metabolichnykh zmin u khvorykh na hipertonichnu khvorobu z tsukrovym diabetom 2 typu ta yikh korektsiya za dopomohoyu kombinatsiyi inhibitoriv APF ta tiazydopodibnykh diuretykiv [The role of impaired carbohydrate and lipid metabolism in the formation of metabolic changes in patients with type 2 diabetes mellitus and their correction by a combination of ACE inhibitors and thiazide-like diuretics]. Ukr terapevtychnyi zhurn. 2011; 3: 34-7. [Ukrainian]
3. IDF Diabetes Atlas update 2012. Available from: http://www.idf.org/diabetesatlas/5e/Update 2012.
4. Dolzhenko MM, Perepelchenko NA, Bazylevych AYa. Ishemichna khvoroba sertsya na tli tsukrovoho diabetu typu 2: osoblyvosti perebihu ta obgruntuvannya terapiyi [Coronary heart disease on the background of type 2 diabetes: features of the course and rationale for therapy]. K: Medknyha; 2010. 100 s. [Ukrainian]
5. Kravchun PP. Stan systolichnoi ta diastolichnoi funktsiyi livoho shlunochka u khvorykh z postinfarktnym kardiosklerozom ta ozhyrinnyam [Condition of left ventricular systolic and diastolic function in patients with postinfarction cardiosclerosis and obesity]. Mizhnarodnyi endokrynolohichnyi zhurnal. 2014; 6: 37-40. [Ukrainian]
6. Kravchun PP. Zminy diastolichnoi funktsiyi miokarda livoho shlunochka u khvorykh iz postinfarktnym kardiosklerozom ta arterialnoyu hipertenziyeyu zalezhno vid stupenya ozhyrinnya [Changes in diastolic function of the left ventricular myocardium in patients with postinfarction cardiosclerosis and hypertension depending on the degree of obesity]. Medytsyna neotlozhnykh sostoyanyi. 2014; 6: 158-60. [Ukrainian]
7. Devereux RB. Left ventricular diastolic dysfunction: early diastolic relaxation and late diastolic compliance. J Am Coll Cardiol. 2009; 24: 337-9. https://doi.org/10.1016/0735-1097(89)90508-1
8. Ono K, Wada H, Satoh-Asahara N, Inoue H, Uehara K, Funada J, et al. ABLE-MET Investigators. Effects of metformin on left ventricular size and function in hypertensive patients with type 2 diabetes mellitus: results of a randomized, controlled, multicenter, phase IV trial. Am J Cardiovasc Drugs. 2019 Nov 13. https://www.ncbi.nlm.nih.gov/pubmed/31721026. https://doi.org/10.1007/s40256-019-00381-1
9. Bizino MB, Jazet IM, Westenberg JJM, van Eyk HJ, Paiman EHM, Smit JWA, et al. Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial. Cardiovasc Diabetol. 2019 Apr 30; 18(1): 55. https://www.ncbi.nlm.nih.gov/pubmed/31039778. https://www.ncbi.nlm.nih.gov/pmc/articles/6492440. https://doi.org/10.1186/s12933-019-0857-6
10. Kadykova OI. Metabolizm vuhlevodiv i lipidiv u khvorykh na ishemichnu khvorobu sertsya y ozhyrinnya z riznymy henotypamy hena interleykina-6 (C-174G) [Metabolism of carbohydrates and lipids in patients with coronary heart disease and obesity with different genotypes of the gene interleukin-6 (C-174G)]. Ukrainskyi terapevtychnyi zhurnal. 2017; 1: 70-5. [Ukrainian]
11. Voronkov LH, Amosova KM, Dzyak GV, Zharinova OY, Kovalenko VM, Korkushko OV, ta in. Rekomendatsiyi Asotsiatsiyi kardiolohiv Ukrainy z diahnostyky ta likuvannya khronichnoi sertsevoi nedostatnosti [Recommendations of the Association of Cardiologists of Ukraine on the diagnosis and treatment of chronic heart failure]. Sertseva nedostatnist ta komorbidni stany. 2017; 1(1): 66 s. [Ukrainian]
12. Sertsevo-sudynni zakhvoryuvannya. Klasyfikatsiya, standarty diahnostyky ta likuvannya [Cardiovascular diseases. Classification, diagnosis and treatment standards]. Za red VM Kovalenko, MI Lutay, YuM Sirenko. Kyiv; 2013. 96 s. [Ukrainian]
13. Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy «Stabilna ishemichna khvoroba sertsya» [Unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care "Stable ischemic heart disease"]. № 152 vid 02.03.2016. [Ukrainian]
14. Unifikovanyi klinichnyi protokol pervynnoi i vtorynnoi (spetsializovanoi) medychnoi dopomohy «Tsukrovyi diabet 2-ho typu» [Unified clinical protocol of primary and secondary (specialized) medical care "Type 2 diabetes"]. № 1118 vid 21.12.2012. [Ukrainian]