Features the interaction of functional and metabolic remodeling of myocardium in comorbid course of ischemic heart disease and 2 type diabetes mellitus

Abstract

Background: Metabolic and structural changes in cardiomyocytes in diabetes mellitus lead to aggravation of contractile myocardial dysfunction in coronary heart disease (CHD). The contractility dysfunction of cardiomyocytes is determined by a change in the levels of sarcoplasmic reticulum (SR) Ca2+-ATPase and energetic supply of the cardiomyocytes.
 Aims: To study the features of functional remodeling of the heart muscle in coronary heart disease with and without type 2 diabetes mellitus (DM2) depend on the level of Ca2+-ATPase and the activity of enzymes involved in energy metabolism.
 Materials and methods: The work was performed on the heart biopsy of patients with CHD and patients with CHD combined with DM2. The inotropic reaction of myocardial strips on rest periods was assessed. The expression level of Ca2+-ATPase, the activity of enzymes succinate dehydrogenase (SDH) and lactate dehydrogenase (LDH) and the intensity of oxidative phosphorylation processes were determined.
 Results: The interval-force relationship in patients with CHD with and without DM2 had both negative and positive dynamics. The positive dynamics corresponds to the "high content" of the Ca2+-ATPase and the negative dynamics corresponds to the "low content" were found. At the combined pathology the positive inotropic dynamics is more pronounced and corresponds to a higher protein level. In the patients myocardium with CHD the activity of SDH and LDH was higher, while the oxygen uptake rate by mitochondria was higher in the myocardium with combined pathology.
 Conclusions: The potentiation of inotropic response of patient myocardium with CHD with and without DM2 corresponds to the "high level" of Ca2+-ATPase. In the combined pathology the inotropic capabilities of the myocardium are more expressed. In CHD the synthesis of ATP in cardiomyocytes is realized mainly due to glycolytic processes and Krebs cycle. In combined pathology the ATP synthesis is realized to a greater extent due to the oxidative phosphorylation.

Expression of Genes and Proteins of the Sarcoplasmic Reticulum Са2+-Transport Systems in Cardiomyocytes in Concomitant Coronary Heart Disease and Type 2 Diabetes Mellitus

“…This probably provides better functionality of SPR and improves the contractile function of the myocardium, even at the level of the whole heart. This conclusion does not contradict our previously published findings, obtained in comparative study of contractile function of heart muscle in CHD without comorbidity and CHD associated with T2DM [2,5].…”

“…The cohort study VALIANT has showed that T2DM is an independent predictor of unfavorable coronary events during the first year after myocardial infarction or patient death [4]. Our previous studies showed that CHD and T2DM comorbidity significantly affects cardiac remodeling at the cellular and molecular levels [1,2,5]. The combined influence of ischemic and diabetic/hyperglycemic factors on the cardiac muscle was also demonstrated in biologic models and in patients with comorbidity.…”

Mechanisms of vibration-induced structural myocardial remodeling

“…Помимо прямого повреждающего действия и опосредованного, через активизацию прооксидантной системы в основе вибрационно-опосредованных изменений лежат нейрогуморальные [8,[16][17][18][19] и нейрорефлекторные нарушения [20,21], усугубляющие гипоксию тканей [7]. У пациентов с ВБ наблюдаются изменения кальциевого гомеостаза, который находится под контролем глюкокортикоидов, соматотропина, кальцийрегулирующих гормонов (паратгормон, кальцитонин) и витамина D [22].…”

Structural and functional indicators of the heart of patients with ischemic heart disease and type 2 diabetes mellitus. Rhythmoinotropic response isolated myocardium at different levels of glycated hemoglobin

“…Набор пациентов проводился в течение 2017-2018 гг. Настоящее исследование включает часть данных, использованных в предыдущей работе [15] Описание медицинского вмешательства Всем пациентам на этапе подготовки к операции коронарного шунтирования проводили обязательные инструментальные и лабораторные обследования. Они включали эхокардиографию сердца и сосудов, а также определение в крови HbA 1c .…”

“…Оценивали величину экстрасистолического (ЭС) и постэкстрасистолического (ПЭС) инотропного ответа мышц, которую выражали в процентах к амплитуде регулярного цикла. Этот подход используют для оценки внутриклеточного гомеостаза ионов кальция [15].…”