MYOCARDIAL REMODELING IN PATIENTS WITH CORONARY ARTERY DISEASE AND TYPE 2 DIABETES MELLITUS

Abstract The aim of the work was a comparative study of the structural and geometric remodeling of the myocardium in patients with coronary heart disease with and without concomitant type 2 diabetes. 110 patients with coronary artery disease who had previously undergone myocardial revascularization were examined, with an average age of 58.3 ± 4.9 years. The patients were divided into two groups. The first main group consisted of 56 patients with coronary artery disease. Stable angina pectoris FC 2 with concomitant type 2 diabetes, the second comparison group included 54 patients with coronary heart disease, without diabetes. The control group consisted of 20 practically healthy individuals. All examined patients underwent medical history collection, ECG, EchoCG, and blood determination of glycated hemoglobin. There was a tendency to decrease LVEF, an increase in cavity dilation and an increase in LV myocardial mass in the group of coronary heart disease with type 2 diabetes compared with the group of coronary heart disease without diabetes. Concentric LVH was found in 14 (25%) patients, concentric LV remodeling in 24 (42.8%) patients, eccentric LVH in 14 (25%) patients, and normal left ventricular geometry in 4 (7.1%) patients. The relationship between the level of glycated hemoglobin and the presence of left ventricular hypertrophy was revealed: in the main group in 14 patients, 80% of them had HbA1c levels of more than 6.5%, including HbA1c levels of more than 7.5% to 45.4% of patients (p<0.05). Thus, the study of the features of the structural and functional restructuring of the left heart in patients with coronary artery disease with type 2 diabetes should be taken into account in predicting cardiovascular risk.