Skybchik V. A., Myzak Y. V., Vosukh O. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The most common diseases that are often comorbid today are coronary heart disease (CHD) and type 2 diabetes mellitus (DM 2). The results of epidemiological studies suggest that the risk of coronary complications in patients with DM 2 without CHD is equal to the risk in patients with already confirmed CHD. It is important to note that the presence of two diseases causes the development of chronic heart failure (CHF) and as it was shown by some studies patients with CHD in combination with DM 2 without signs of CHF with an increase in glycated haemoglobin (HbA1c) by 1% was accompanied by an increased risk of CHF by 36% within 4 years of follow-up. The aim of the study was to determine the influence of risk factors on quality of life in patients with stable angina FC II-III and type 2 diabetes with different types of heart failure. The study involved 45 patients (men – 66.6%, women 33.4%, mean age – 62.1±7.1 years) with CHD (stable angina (SA) FC II-III) – group I and 37 patients (men – 62.1%, women 37.9%, mean age – 62.6±8.9 years) with CHD (SA FC II-III) and DM 2. HbA1c and the level of NT-proBNP in the blood were determined using enzyme-linked immunosorbent assay. An echocardiographic examination was performed to determine the parameters of diastolic and systolic dysfunction of the left ventricle. In addition, an anonymous survey on the quality of life of patients with CHF was evaluated using the questionnaire (MLHFQ) Minnesota Living with Heart Failure Questionnaire at the time of discharge. According to the results, it was found that in patients with SA and DM 2 during the echocardiography systolic dysfunction of the left ventricle is dominated – 65%, while in patients with SA without DM 2 diastolic dysfunction of the left ventricle type 1 is predominant – 55%. All examined patients showed a moderate decrease in quality of life, especially in patients with existing factors in the development of CHF (hypertension, smoking, obesity, dyslipidaemia). However, in patients with comorbid pathology (SA and DM 2), subjective assessment of their condition indicated presumably worse indicators. Patients with SA and DM 2 have higher NT-proBNP values (252.8±69.8 pg/ml) even in the initial stages of the disorder of left ventricle (type I of diastolic dysfunction) than patients with SA (177.3±81.2 pg/ml). These results showed that patients with SA II-III FC and type 2 diabetes have a more severe course of CHF, as evidenced by the predominance of systolic dysfunction of the left venricle. In contrast, the absence of risk factors in patients with stable angina may be the basis for a favorable course of CHF and a better quality of life, as evidenced by the results on quality of life (using the MLHFQ).

coronary heart disease, stable angina, diabetes mellitus, chronic heart failure, risk factors

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«Bulletin of problems biology and medicine» Issue 3 (161), 2021 year, 143-148 pages, index UDK 616.12-009-039.33+616.379-008.65]-036.864-038

10.29254/2077-4214-2021-3-161-143-148