BACKGROUND: Despite advances in modern clinical cardiology, chronic heart failure (CHF) remains the leading cause of death and hospitalization. The combination of CHF and type 2 diabetes mellitus (DM2) accelerates the pathophysiological processes, accounting for CHF decompensation. Considering that 30-60% of patients with CHF and DM2 are asymptomatic, early detection of CHF predictors is an important medical, social and economic issue.
AIM: was to determine the informativeness of mitochondrial stress test assessment in patients with CHF and DM2.
METHODS: Twenty-three middle-aged patients with CHF with preserved ejection fraction (CHF-pEF) and CHF with reduced ejection fraction (CHF-rEF) were studied. Patients were divided into groups according to the presence of concomitant DM2. Mitochondrial stress testing was performed using a Seahorse XFe96 Extracellular Flux Analyser. Analysis of mitochondrial respiratory function in adherent mononuclears was assessed by simultaneous measurement of oxygen consumption rate and extracellular proton current.
RESULTS: In patients with DM2, basal respiration was 1.5 times lower than in the control group, and reserve respiration was reduced 3.5 lower. The most depressing effect of DM2 on mitochondrial respiration rate was observed in cases with CHF-rEF: 2.1-3.0 times less compared to the control group. The presence of DM2 suppresses reserve respiration, so that in groups with isolated CHF index values are 2.4 - 4.5 times less, and in cases with DM2 - 18.0 times. In addition, in patients with DM2 the suppression of non-mitochondrial respiration was observed. Index values were reduced by 1.28 in comparison with the controls.
CONCLUSION: The pronounced mitochondrial dysfunction found in comorbid patients is comparable to the rapid clinical development of CHF associated with DM2 and the high frequency of decompensated clinical cases. Reduced basal respiration and respiratory reserve are crucial factors for CHF development in patients with DM2.
