Status of the collagen metabolism and intracardiac hemodynamics in patients with mitral valve prolapse and diabetes mellitus type 1

Abstract

Summary. Mitral valve prolapse is a significant cardiovascular risk factor in young adults. Its combination with type 1 diabetes mellitus can influence the nature and development of the disease. Objective – a comparative analysis of free and peptide-bound oxyproline levels and basic echocardiographic parameters (ECP) in patients with mitral valve prolapse, type 1 diabetes and their combination. Materials and methods – 93 people aged 19–33 years were examined, including 24 people with mitral valve prolapse without concomitant pathology; 33 patients with mitral valve prolapse and type 1 diabetes; 36 patients with type 1 diabetes without mitral valve prolapse. Results. The level of free and peptide-bound oxyproline in blood serum and their ratio were assessed as a marker of collagen metabolism. The levels of free oxyproline were significantly higher only for the group of MVP patients with type 1 diabetes (p < 0.05) compared to the control group. Severity of destructive processes was demonstrated by a high level of peptide-bound oxyproline, both in combined pathology compared with control group, and compared with groups of patients with monomorbid diabetes and MVP (p < 0.05). In patients with mitral valve prolapse and type 1 diabetes for more than 10 years in anamnesis were found significant differences in the echocardiography parameters (ventricular septum thickness, posterior wall of the left ventricle thickness) compared with the subgroup of patients with less than 10 years of type 1 diabetes in anamnesis and the group with isolated mitral valve prolapse. Conclusions. The data obtained indicate an aggravation in collagen metabolism disorders in patients with mitral valve prolapse depending on the duration of type 1 diabetes, and demonstrate the effect of carbohydrate metabolism disorders on the risk of developing connective tissue degradation of the heart valve apparatus.