LEFT VENTRICULAR HYPERTROPHY IN DIABETES MELLITUS TYPE 2

Objective: To evaluate the impact of left ventricular hypertrophy (LVH) and changes in NT-proBNP levels in patients with diabetes mellitus type 2 (DM2). Design and method: We studied 156 patients with DM2 and atherosclerotic cardiovascular disease (ASCVD). The average age of the patients was 65.45 ± 7.4 years, with 34% men and 66% women. The structural and functional states of the myocardium were assessed by Doppler echocardiography. The examination was performed using the transthoracic approach in the M and B modes according to the recommendations of the American Society of Echocardiography. Patients with a preserved ejection fraction (EF) were included in the study. NT-proBNP was determined using an electrochemiluminescence immunoassay (ECLIA; Roche). Statistical analyses were performed using IBM SPSS Statistics version 27.0. Results: Patients were divided into two groups based on the presence of LVH:Group 1 consisted of patients with LVH (n=110), and group 2 consisted of patients without LVH (n=46). The groups were compared in terms of age and sex. Left ventricular myocardial mass (LVMM) and left ventricular myocardial mass index (LVMMI) were significantly higher in Group 1 compared to Group 2:LVMM – 263.5±46.05 vs 198.9±57.5 g/m2, p=0.001; LVMMI – 166.33±33.6 vs 135.13±43.8 g/m2, p=0.001. Patients with LVH had higher systolic blood pressure (SBP), and diastolic blood pressure (DBP): SBP - 136.87±18.8 vs 130.88±16.8 mm Hg, p<0.018 and DBP - 86,15±10,5 vs 82,56±10,09 mm Hg, p<0.014. LVEF was preserved in both groups, and no significant difference was found between the groups: 60.9±4.1% vs 59.7±5.58%, p=0.3). The left atrial index (LAI) was significantly higher in patients with LVH: LAI – 25.1±8.3 vs 13.8±12.1 cm, p=0.001. NT-proBNP levels were significantly higher in Group 1 (153 pg/mL [54.5-372.7] vs. 47 [26-200] pg/mL. A positive correlation was found between LVH and LAI (r=0.4, p=0.001) and NT-proBNP levels (r=0.2, p=0.042). A greater number of patients had concentric hypertrophy when analyzing the types of LV remodelling. Normal geometry comprised 8.5% of patients; concentric remodeling, 6.4%; concentric hypertrophy, 78%; eccentric hypertrophy, 7.1%; X2=211.48, p<0.001). Conclusions: The development of LVH in patients with DM led to a significant increase in NT-proBNP levels.

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