CLINICAL AND INSTRUMENTAL ASSESSMENT OF MORPHO-FUNCTIONAL CONDITION OF THE HEART AND VASCULATURE IN COMORBIDITY OF ARTERIAL HYPERTENSION AND DIABETES MELLITUS TYPE 2

N. Babayeva
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Abstract

The aim of this study was to investigate the heart and common carotid arteries (CCA) morphological and functional condition and the lipid spectrum in patients with arterial hypertension (AH) and type 2 diabetes mellitus (DM-2).Material and methods. The study included 144 patients with varying degrees of AH, 103 had AH without DM-2 (AH subgroup) and 41 patients with AH and DM-2 (AH+DM-2 subgroup). In all investigated patients the blood plasma lipid profile, echocardiographic examination of the heart and ultrasound Doppler examination of the CCA were carried out. The results. Significant differences between the AH and AH+DM-2 subgroups were discovered, which confirmed the significant effect of DM-2 on various parameters of the cardiovascular system. The lipid profile in the above mentioned subgroups has not significant differences, but some separated indices (TG, VLDL) in the AH+DM-2 subgroup were comparatively higher and HDL level lower comparing to AH subgroup. Marked changes in echocardiographic parameters, such as lowering of left ventricle (LV) ejection fraction (EF), significant increase of interventricular septum and LV posterior wall thickness, high frequency of LV hypertrophy detection, diastolic dysfunction, diffuse hypokinesis and dilatation of the heart cavities in the AH+DM-2 subgroup were confirmed. A significant rise of CCA intima-media thickness also was found in the AH+DM-2 in comparison with AH subgroup, which proved the essential role of comorbidity of AH and DM-2 in the heart and vessels remodeling. The conclusion. The results of the study confirm the role and significance of comorbidity of AH with DM-2 in the development of the cardiovascular system pathological changes.
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动脉性高血压合并2型糖尿病患者心脏和血管形态功能状况的临床和仪器评估
本研究旨在探讨高血压(AH)合并2型糖尿病(DM-2)患者的心脏和颈总动脉(CCA)形态、功能状况及脂质谱变化。材料和方法。该研究纳入了144例不同程度AH患者,103例AH无DM-2 (AH亚组),41例AH合并DM-2 (AH+DM-2亚组)。所有被调查患者均进行了血脂、心脏超声心动图检查和CCA超声多普勒检查。结果。AH和AH+DM-2亚组之间存在显著差异,证实了DM-2对心血管系统各项参数的显著影响。上述亚组的脂质谱差异无统计学意义,但AH+DM-2亚组的一些分离指标(TG、VLDL)较AH亚组高,HDL水平较AH亚组低。AH+DM-2亚组超声心动图参数有明显变化,如左心室射血分数(EF)降低,室间隔和左室后壁厚度明显增加,左室肥厚检出率高,舒张功能不全,弥漫性运动减弱,心腔扩张。与AH亚组相比,AH+DM-2组CCA内膜-中膜厚度显著增加,证明AH与DM-2合并症在心脏和血管重构中的重要作用。结论。本研究结果证实了AH与DM-2合并症在心血管系统病变发展中的作用和意义。
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