Vysotska K. Prediction of the course of heart failure in patients with coronary heart disease in combination with type 2 diabetes mellitus

An examination of 100 male patients with chronic heart failure (CHF) of ischemic genesis and coronary heart disease (CHD) in combination with type 2 diabetes mellitus (DM) was performed. All patients were examined on the basis of the internal medicine department of the municipal non-profit enterprise City Clinical Emergency Hospital named after Prof. A. I. Meshchaninov of the Kharkiv City Council, after a course of treatment in a hospital. Inclusion criteria: age from 50 to 70 years old, CHF class I-II according to NYHA classification (New York Heart Association), LV EF ≥ 50 % (according to the criteria of the European Society of Cardiology, 2016), post-infarction cardiosclerosis, in combination with type 2 DM (according to the criteria of the American Diabetes Association (ADA), with a glomerular filtration rate ≥ 50 ml / min / 1.73 m2, NT-proBNP ≥ 125 pg/ml. Patients in the subgroup, who after 12 months of follow-up showed a decrease in systolic LV function, were characterized by significant reductions in the median distance of the test with a 6-minute walk (4.1 %), indicating a natural deterioration in exercise tolerance against reduced myocardial contractility. A set of indicators was determined, the levels of which allowed to predict the nature of the unfavorable course of CHF during the year in patients with CHD with concomitant type 2 DM. A method for determining the nature of the adverse course of CHF on the basis of laboratory (LDL and NT-proBNP) and values of cardiovascular ultrasound (SV, E / e ′, LV ESV) has been developed. Based on the research, an algorithm for predicting the adverse course of CHF in patients with CHD in combination with type 2 DM, which with high sensitivity and specificity allows to predict the adverse course of CHF and its variants in the form of progression of systolic or diastolic dysfunction.