Structural and Functional Changes of the Myocardium in Case of Comorbidity of Postinfarction Cardiosclerosis and Type 2 Diabetes

Introduction. Such diseases as coronary heart disease (CHD) and diabetes mellitus (DM) are common and their prevalence is constantly increasing. The information accumulated in the modern professional literature makes it possible to study the peculiarities of the appearance of systolic and diastolic dysfunction in patients with CHD, especially after the myocardial infarction, due to the appearance of the structural and functional myocardial changes, left ventricular (LV) geometry, and its remodeling, that depends on the presence of risk factors, in particular, type 2 DM. Aim. To evaluate the parameters of the geometry of the left ventricle in patients with post-infarction cardiosclerosis and concomitant type 2 diabetes depending on the systolic function of the LV and functional class of the chronic heart failure. Materials and methods. The study involved 68 patients with post-infarction cardiosclerosis and type 2 diabetes. The comparison group consisted of 80 patients with postinfarction cardiosclerosis and control group – of 35 healthy individuals. Results. Type 2 diabetes is a predictor of the development of concentric hypertrophy of LV in patients with post-infarction cardiosclerosis, which is a reaction of the heart on the prolonged loading and violation of microcirculation in the myocardium, and also leads to a complex structural and functional reorganization of the heart with the emergence of mainly concentric remodeling and concentric hypertrophy of LV with a tendency to reduce the contractile capacity of the myocardium.The increase of the functional class of chronic heart failure in patients with post-infarction cardiosclerosis was associated with progression of LV hypertrophy, decreased inotropic function of the myocardium, increased size and volume of LV cavity, deterioration of the functional status, which is undoubtedly a consequence of the underlying disease and type 2 diabetes. This suggests that the mechanisms underlying the disease are associated with glucose and insulin metabolism disorders, which leads to remodeling of LV in patients with post-infarction cardiosclerosis and type 2 diabetes. Conclusions. Type 2 diabetes is a potentiator of LV myocardial remodeling in patients with systolic dysfunction, which originated on the basis of postinfarction cardiosclerosis. Comorbidity of post-infarction cardiosclerosis and type 2 diabetes leads to an increase in the severity of post-infarction remodeling associated with an increase in the functional class of chronic heart failure.