The course of chronic heart failure in persons with post-infarction cardiosclerosis and type 2 diabetes mellitus and obesity according to a number of metabolic and hormonal indicators.

Abstract

The aim of the study is to investigate the effect of lipid metabolism, biomarkers of fractalkin and clusterin inflammation on the development and progression of chronic heart failure (CHF) in patients with post­infarc­tion cardiosclerosis, type 2 diabetes and obesity. Materials and methods. A retrospective analysis of a comprehensive examination of 67 patients with postinfarction cardiosclerosis with concomitant type 2 diabetes and obesity. All patients were divided into 3 groups depending on the functional class (FC) of CHF: 1 group (n = 22) — patients with CHF II FC; Group 2 (n = 23) — patients with CHF III FC; Group 3 (n = 22) — patients with CHF IV FC. All patients were examined clinically, they underwent instrumental, biochemical and hormonal examinations. Results. With the progression of CHF from FC II to FC III there is a deterioration of lipid metabolism: a significant increase in cholesterol levels by 5.5 %, TG — by 15.7 %, LDL cholesterol — by 74.4 %, VLDL cholesterol — by 15.9 %, reduction of HDL cholesterol by 27.6 % (p < 0,05). An analysis of the fractal equation showing that ailing on CHF is advised by FC; and the level of clusterine — on the contrary decreases. Classical changes in patients with postinfarction cardiosclerosis with CHF and concomitant type 2 diabetes mellitus and obesity, which are the formation of atherogenic lipid metabolism disorders associated with body weight, as well as changes in the latest indicators such as fractalkin and clusterin, indicating the role of these molecules in the progression of CHF.Conclusions. Due to the progression of chronic heart failure in patients with postinfarction cardiosclerosis and concomitant type 2 diabetes and obesity, an increase in all fractions of lipoproteins at stage III functional class was diagnosed, and then their decrease (at stage IV functional class), which may indicate a deterioration in this category of patients. , due to the progression of metabolic shifts, stagnation, dysfunction of the main parenchymal organs. Increased circulatory levels of fractalkin and decreased clusterin content in patients with postinfarction cardiosclerosis with concomitant type 2 diabetes mellitus and obesity is accompanied by an in­crease in the functional class of chronic heart failure. Fractalkin and clusterin play a significant role in the pro­gression of chronic heart failure in patients with postinfarction cardiosclerosis with concomitant type 2 diabetes and obesity, so they can be used as biomarkers of the severity of heart failure.