The Relationship Between Glycemia and Heart Failure in Patients with Coronary Heart Disease and Diabetes Mellitus 2

2021 
Abstract Introduction There are differences in the development of heart failure in patients with coronary heart disease (CHD), depending on the presence of diabetes mellitus (DM) 2. Purpose To assess the relationship between glycemic variability (GV) parameters and left ventricular diastolic function (LVDF) in patients with CHD and diabetes. Methods We examined 50 patients with CHD with DM 2 at the age of 62.8 ± 1.29 years. Glycemic variability (GV), HbA1c, mitral flow rate E and mitral e 'annular velocity (E/e') were determined. Arranged in groups with HFpEF n-33, HFmrEF n-17. Treatment regimen: basic therapy of CHD, sitagliptin/metformin. Follow-up for 48 weeks. Results In patients with high GV (mean SD ≥ 2.1 mm / l /) E / e 'was significantly higher than in patients with low GV (12.4 ± 2.8 versus 10.1 ± 3.1, p = 0.02), and did not depend on the EF indicator. There was no dependence of E / e 'on the mean HbA1c value of 8.67 ± 0.46%, which also did not differ in patients depending on the parameter of the ejection fraction. However, regression analysis showed that E / e '> 14 predominant in the group of patients with HFmrEF is independently associated with GV ≥ 2.1 mm/l. Conclusion When selecting therapy for patients with CHD and DM with HFmrEF, it is advisable to take into account the GV value in patients with E/e '> 14.
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