ENDOTHELIAL FUNCTIONAL STATUS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS AFTER COVID-19
Abstract
Objective: Aim of the study was to estimate endothelial functional status in patients with hypertension and type 2 diabetes mellitus (T2DM) who underwent Covid-19. Design and method: 56 patients with hypertension and T2DM after coronavirus infection (Group I) and 56 patients with hypertension and T2DM without any history of Covid-19 (Group II) were enrolled in this study. Group I patients aged 43-75 years, mean age 62.4±12.5 years; male = 46% and Group II patients aged 42-77 years, mean age 63.6±13.7 years; male = 43%. Endothelial functional status was assessed by flow-mediated vasodilation of brachial artery (FMD). All statistical analysis were performed by SPSS 26.0 software. Results: FMD of brachial artery was significantly decreased in patients with hypertension and T2DM after Covid-19 than those patients without Covid-19 (P<0.01). There were a correlation between Covid-19 and reduced FMD in Group I (r = 0.7, CI 95%, P = 0.032). When we assessed systolic function of the left ventricle, there were a positive correlation between reduced FMD and low ejection fraction (r = 0.6, CI 95%, P = 0.028), however this correlation were more pronounced in Group I (P = 0.001). Multivariate analysis revealed that reduced flow-mediated vasodilation of brachial artery was independent predictor of poor systolic function of patients with hypertension and T2DM especially in those after Covid-19 (odds ratio [OR] 1.52, P = 0.026). When we separately analyzed between men and women there were not any statistical significant changes between male and female (P>0.05). Conclusions: Patients with hypertension and type 2 diabetes mellitus after Covid-19 had impaired FMD of brachial artery. Even though, there were positive correlation between flow-mediated vasodilation of brachial artery and reduced ejection fraction, patients with hypertension and T2DM after Covid-19 had strong correlation of it. In hypertensive patients with type 2 diabetes mellitus who have undergone Covid-19, FMD independently associated with poor left ventricular systolic function.