Clinical-instrumental parameters, NT-proBNP level and indicators of quality of life in patients with heart failure and moderately reduced left ventricular ejection fraction depending on the presence of type 2 diabetes mellitus

Abstract

The aim: to evaluate effects of type 2 diabetes mellitus (DM 2) on the quality of life, clinical, biochemical and ultrasonographic parameters in patients with heart failure and moderately reduced left ventricular ejection fraction (HFwmrLVEF).
 Materials and methods. The study involved 68 patients with HFwmrLVEF, including 36 patients with concomitant DM 2 and 32 patients without DM 2, and 18 healthy individuals. All study participants underwent anthropometric (height, weight, BMI), laboratory (clinical blood test, biochemical blood test to determine ACT, ALT, creatinine, glucose, lipid spectrum, potassium, sodium and magnesium, ELISA to determine glycated hemoglobin and NT‑proBN), instrumental (EchoC, ECG) surveys and surveys to assess quality of life (EQ‑5D‑5L). Statistical processing of the obtained results was performed using the statistical software package SPSS v.19.0.
 Results. It has been established that patients with HFwmrLVEF and concomitant DM 2 in comparison with the subjects without DM 2 had significantly worser indices of carbohydrate metabolism, higher mean serum levels of NT‑proBNP, higher LV myocardial mass (LVMM) and LVMM index (іLVMM) based on the results of transthoracic Echo; they had worser quality of life as per the EQ­5D­5L results with absence of significant difference between the groups in the age and LV ejection fraction. The stronger correlation between NT­proBNР levels and іLVMM was established in patients without DM2, and absence of correlation between NT­proBNР levels and LVMM in subjects with the concomitant DM2, that may be due to some effects of DM2 on the process of pro­BNP conversion.
 Conclusions. Patients with HFwmrLVEF with concomitant type 2 DM compared to the subjects with HFwmrLVEF without type 2 DM had significantly worser carbohydrate metabolism, significantly higher mean serum NT‑proBNP levels, higher LVMM and iLVMM as per the results of transthoracic EchoC, worser quality of life according to the results of the EQ‑5D‑5L questionnaire in the absence of a significant difference in age and LVEF between the groups. In addition, there was a stronger correlation between NT‑proBNP and iLVMM in patients without type 2 DM and no correlation between NT‑proBNP and LVMM in patients with concomitant type 2 DM, which may be due to certain influence of type 2 DM on the process of pro‑BNP conversion