| About the author: |
O. M. Bilovol, I. I. Kniazkova, O. M. Kirienko, N. V. Kuzminova, A. S. Sushetska, V. P. Starenkiy, L. P. Abramova |
| Heading |
CLINICAL MEDICINE |
| Type of article |
Scentific article |
| Annotation |
The purpose of our study was to investigate the effect of complex therapy with the addition of eplerenone and trimetazidine on the state of left ventricular diastolic function, as well as levels of soluble growth-stimulatingreceptor expressed by gene 2 and N-terminal fragment of brain natriuretic propeptide in patients with arterial hypertension with type 2 diabetes mellitus. After registration baseline data were recorded, 42 patients (group 1) were prescribed baseline therapy and 38 patients (group 2) were prescribed eplerenone 25-50 mg once daily and trimetazidine 80 mg once daily in addition to antihypertensive therapy for 3 months. The control group consisted of 20 practically healthy individuals. After the treatment, a significant decrease in the level of soluble growth-stimulatingreceptor expressed by gene 2 in the blood of patients in both groups was found, but in group 2 this indicator did not differ from the control group, while in group 1 it remained significantly higher than in healthy individuals. At the same time, the level of N-terminal fragment of brain natriuretic propeptide significantly decreased by 1.3 times and 1.6 times in groups 1 and 2, respectively, but remained significantly higher than in the control group. A significant decrease E/e`mean was determined in both groups of patients, but in group 2 by 8.9 % less than in group 2 and a decrease in the geometric parameters of the left atrium, more pronounced in group 2. Thus, the addition of eplerenone and trimetazidine to the complex therapy of patients with arterial hypertension and type 2 diabetes mellitus during 3 months improved diastolic function, and also had a positive effect on the biomarker of myocardial stress and fibrosis soluble growth-stimulatingreceptor expressed by gene 2 level and myocardial dysfunction N-terminal fragment of brain natriuretic propeptide concentration in serum |
| Tags |
soluble growth-stimulatingreceptor expressed by gene 2,N-terminal fragment of brain natriuretic propeptide,diastolic function,arterial hypertension,type 2 diabetes mellitus,eplerenone,trimetazidine |
| Bibliography |
- Zhdan VM, Babanina MY, Kitura EM, Tkachenko MV, Shylkina LM, Kiryan OA. Klinichni pidkhody do terapiyi arterialnoyi hipertenziyi u zhinok u period postmenopauzy. Family medicine. 2019. No. 2 (82). P. 76–79 [in Ukrainian]
- Almourani R, Chinnakotla B, Patel R, Kurukulasuriya LR, Sowers J. Diabetes and Cardiovascular Disease: an Update. Curr Diab Rep. 2019;19(12):161. doi: 10.1007/s11892-019-1239-x.
- Biernacka A, Frangogiannis NG. Aging and Cardiac Fibrosis. Aging Dis. 2011 Apr;2(2):158–173. PMID: 21837283; PMCID: PMC3153299.
- Carpenito M, Fanti D, Mega S, Benfari G, Bono MC, Rossi A, Ribichini FL, Grigioni F. The Central Role of Left Atrium in Heart Failure. Front Cardiovasc Med. 2021 Aug 13; 8:704762. doi: 10.3389/fcvm.2021.704762.
- Luke P, Eggett C, Spyridopoulos I, Irvine T. A comparative analysis of British and American Society of Echocardiography recommendations for the assessment of left ventricular diastolic function. Echo Res Pract. 2018 Dec 1;5(4):139–147. doi: 10.1530/ERP-18-0024.
- Morfino P, Aimo A, Castiglione V, Gálvez-Montón C, Emdin M, Bayes-Genis A. Treatment of cardiac fibrosis: from neuro-hormonal inhibitors to CAR-T cell therapy. Heart Fail Rev. 2023 Mar;28(2):555-569. doi: 10.1007/s10741-022-10279-x.
- Müller-Brunotte R, Kahan T, López B, Edner M, González A, Díez J. et al. Myocardial fibrosis and diastolic dysfunction in patients with hypertension: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation versus Atenolol (SILVHIA). J Hypertens. 2007 Sep;25(9):1958–66. doi: 10.1097/HJH.0b013e3282170ada.
- Parovic M, Okwose NC, Bailey K, Velicki L, Fras Z, Seferovic PM. et al. NT-proBNP is a weak indicator of cardiac function and haemodynamic response to exercise in chronic heart failure. ESC Heart Fail. 2019 Apr;6(2):449–454. doi: 10.1002/ehf2.12424.
- Rubiś P, Dziewięcka E, Szymańska M, Banyś R, Urbańczyk-Zawadzka M, Krupiński M, et al. Lack of Relationship between Fibrosis-Related Biomarkers and Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis in Dilated Cardiomyopathy. Cells. 2021 May 23;10(6):1295. doi: 10.3390/cells10061295.
- Sundqvist MG, Sahlén A, Ding ZP, Ugander M. Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings. Cardiovasc Ultrasound. 2020 Nov 20;18(1):46. doi: 10.1186/s12947-020-00228-9. PMID: 33218338; PMCID: PMC7679986.
- Todo, S., Tanaka, H., Yamauchi, Y. et al. Association of left ventricular longitudinal myocardial function with subclinical right ventricular dysfunction in type 2 diabetes mellitus. Cardiovasc Diabetol. 2021; 20: 212. https://doi.org/10.1186/s12933-021-01404-5
- Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, Wainford RD, Williams B, Schutte AE. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020 Jun;75(6):1334–1357. doi: 10.1161/HYPERTENSIONAHA.120.15026.
- Vergaro G, Gentile F, Aimo A, Januzzi JL Jr, Richards AM, Lam CSP, et al. Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure. ESC Heart Fail. 2022 Aug;9(4):2084–2095. doi: 10.1002/ehf2.13883.
- Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A. et al. ESC National Cardiac Societies; ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021 Sep 7;42(34):3227–3337. doi: 10.1093/eurheartj/ehab484.
- Zhang T, Xu C, Zhao R, Cao Z. Diagnostic Value of sST2 in Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2021 Jul 23; 8:697837. doi: 10.3389/fcvm.2021.697837.
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| Publication of the article |
«World of Medicine and Biology» №1(83), 2023 year, 021-025 pages, index UDK 616.12-008.331.1+616.379-008.64]-085.225.2-078 |
| DOI |
10.26724/2079-8334-2023-1-83-21-25 |
