CLINICAL AND FUNCTIONAL FEATURES OF CARDIOMYOPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH OPTIMIZED METABOLIC THERAPY

Type 2 diabetes mellitus remains the leading cause of cardiovascular disease. Diabetic cardiomyopathy is an independent myocardial disorder that develops due to metabolic disturbances in the absence of significant coronary atherosclerosis. The study included 142 patients with type 2 diabetes mellitus for more than 5 years without arterial hypertension or coronary artery disease. Clinical and functional features were assessed using echocardiography with tissue Doppler ultrasonography and laboratory diagnostics (HbA1c, NT-proBNP, malondialdehyde, and superoxide dismutase). A decrease in E' velocity to <7 cm/s, which correlates with diabetes duration, was found to be an early marker of dilated cardiomyopathy. A 12-week metabolic therapy regimen (trimetazidine 35 mg x2 + meldonium 500 mg x2) was developed and tested. In the study group, improvement in diastolic function (increase in E' by 20%, decrease in E/E' by 22%), a 41% decrease in NT-proBNP, and a reduction in oxidative stress (malondialdehyde decreased by 35%, superoxide dismutase increased by 32%) were achieved. An algorithm for early diagnosis and treatment is proposed.

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