Особливості клінічного перебігу хронічної серцевої недостатності у хворих з постінфарктним кардіосклерозом за наявності супутнього цукрового діабету 2 типу та ожиріння

Abstract

В исследовании были определены особенности клинического течения хронической сердечной недостаточности у больных с постинфарктным кардиосклерозом при наличии сопутствующего сахарного диабета 2 типа и ожирения. Анализируя данные исследования, наиболее отягощающее влияние на клиническое течение постинфарктного кардиосклероза происходит при наличии сопутствующих сахарного диабета 2 типа и ожирения, что позволяет расценивать диабет и ожирение как факторы риска развития и прогрессирования хронической сердечной недостаточности Coronary heart disease is the leading cause of death for men and women in the Europe and United States. Risk factors for coronary heart disease include diabetes and obesity. Diabetes mortality has become an increasing concern in recent years as rates of diabetes grow alongside the obesity epidemic. Improving the efficiency of diagnosis and increased education efforts as well as preventive screenings can greatly reduce the impact of diabetes and obesity on patient with coronary heart diseases. The study is devoted to defining features of the clinical course of chronic heart failure in patients with coronary heart diseases after myocardial infarction and concomitant type 2 diabetes and obesity. The nature of the clinical course of heart failure in 215 patients with coronary heart diseases after myocardial infarction were compared with that of patients who had not diabetes and obesity (comparison group (n = 80)). All patients with coronary heart diseases after myocardial infarction were divided into groups depending on the presence of type 2 diabetes (first group (n = 68)), obesity (the second group (n = 76)) and their combined course (the third group (n = 71)). Patients of all groups were matched by age. All patients underwent comprehensive in conformity with the decree №436 of MoH of Ukraine “Protocols on delivery of medical care to the patients with Ischemic Heart Disease”. The statistical processing of results was performed with the help of software package «Statistika» (StaSoftInc, USA). The values calculated: the average (M), dispersion, standard deviation, the median (m), accuracy and level of significance (p). The standard programme of correlation analysis with calculation of average arithmetic means was used: M+m, σ, and level of accuracy (p). Pearson correlation coefficient was applied to evaluate the interaction stage between the samples (r). Diabetes can impair the pathophysiology of chronic heart failure adverse effects, affecting the function of the myocardium, peripheral microcirculation, activating the neurohumoral system, worsening renal function due to diabetic nephropathy. Thus, diabetes is an independent factor in worsening prognosis in heart failure - increases the clinical severity of heart failure, increases the number of repeat hospitalizations and increased mortality. Obesity is a risk factor also that triggers the formation of cardiovascular complications, including progressive heart failure decompensation. This study is demonstrated that in patient with coronary heart diseases after myocardial infarction and concomitant type 2 diabetes and obesity there were burdened by clinical current.