Klinicheskaia meditsina · 2013
[Effect of dyssynchrony on myocardial remodeling in patients with chronic heart failure associated with type 2 diabetes mellitus].
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Vlasenko M A, Rodionova Iu V
Аннотация
UNLABELLED: The study included patients with chronic heart failure (CHF) associated with type 2 diabetes mellitus (DM). Dyssynchrony (DS) is a frequent cause of unfavourable prognosis in CHF patients. The relationship between DS and left ventricle (LV) geometry in patients with CHF and DM is virtually unexplored.
AIM: To estimate effects of DS and left bundle branch block (LBBB) on LV geometry in patients with CHF and DM.
MATERIALS AND METHODS: The study included 61 patients with CHF of ischemic etiology (NYHA II-IV FC) divided between 4 groups. Group 1: patients with CHF without type 2 DM, group 2: patients with CHF and type 2 DM, group 3: patients with CHF, type 2 DM, and DS, group 4: patients with CHF, type 2 DM, DS, and LBBB. Interventricular DS was determined by standard Doppler EchoCG in the pulsed-wave regime.
RESULTS AND DISCUSSION: Remodeling in patients of group 1 and 2 was presented mainly by concentric heart hypertrophy (73.3% and 57.89% respectively, p < 0.05) compared with 20 and 14.3% in groups 3 and 4 (p < 0.05). Concentric remodeling occurred in 33.3 and 28.5% of the patients in groups 3 and 4 respectively. Eccentric hypertrophy was documented in all groups except group 1; it was more frequent in the presence of DS (46.6 and 57.14% in groups 3 and 4 respectively). Normal LV geometry and concentric hypertrophy was characteristic of patients with NYHA II FC CHF and eccentric hypertrophy in those with NYHA ILL-IV FC CHF.
CONCLUSION: Myocardial remodeling associated with DM2 and DS is characterized by formation of different types of myocardial geometry. Structural and functional changes in LV myocardium represented by eccentric hypertrophy are especially well pronounced in patients with CHF, type 2 DM, DS, and LBBB.
AIM: To estimate effects of DS and left bundle branch block (LBBB) on LV geometry in patients with CHF and DM.
MATERIALS AND METHODS: The study included 61 patients with CHF of ischemic etiology (NYHA II-IV FC) divided between 4 groups. Group 1: patients with CHF without type 2 DM, group 2: patients with CHF and type 2 DM, group 3: patients with CHF, type 2 DM, and DS, group 4: patients with CHF, type 2 DM, DS, and LBBB. Interventricular DS was determined by standard Doppler EchoCG in the pulsed-wave regime.
RESULTS AND DISCUSSION: Remodeling in patients of group 1 and 2 was presented mainly by concentric heart hypertrophy (73.3% and 57.89% respectively, p < 0.05) compared with 20 and 14.3% in groups 3 and 4 (p < 0.05). Concentric remodeling occurred in 33.3 and 28.5% of the patients in groups 3 and 4 respectively. Eccentric hypertrophy was documented in all groups except group 1; it was more frequent in the presence of DS (46.6 and 57.14% in groups 3 and 4 respectively). Normal LV geometry and concentric hypertrophy was characteristic of patients with NYHA II FC CHF and eccentric hypertrophy in those with NYHA ILL-IV FC CHF.
CONCLUSION: Myocardial remodeling associated with DM2 and DS is characterized by formation of different types of myocardial geometry. Structural and functional changes in LV myocardium represented by eccentric hypertrophy are especially well pronounced in patients with CHF, type 2 DM, DS, and LBBB.