Russian Heart Failure Journal 2013year Circulating factors associated with metabolic disorders in patients with post-infarction heart failure


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2013/№4

Circulating factors associated with metabolic disorders in patients with post-infarction heart failure

Kochegura T.N.1, Makarevich P.I.1, Ovchinnikov A.G.2, Zhigunova L.V.2, Lakhova E.L.2, Masenko V.P.2, Parfenova E.V.2, Ageev F.T.2
1 –Federal State Budgetary Educational Institution of Higher Professional Education “M. V. Lomonosov Moscow State University”, Leninskie Gory 1, GSP-1, Moscow 119991
2 – Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: diagnostics, metabolic disorders, CHF

DOI: 10.18087 / rhfj.2013.4.1863

Background. Data of epidemiological studies have shown that CHF remains one of the most severe, unresponsive and prognostically unfavorable complications of IHD. The cohort of IHD patients with concurrent metabolic disorders is understudied. Aim. Searching for new diagnostic markers and potential mechanisms of complicated CHF with concurrent metabolic disorders. Materials and methods. The study included 100 patients who were divided into 4 groups: 20 relatively healthy volunteers, 30 patients with post-infarction CHF, 24 CHF patients with concurrent type 2 DM (CHF+DM2) and 26 DM2 patients without CHF. The study protocol included a standard clinico-laboratory examination, measurement of circulating MR-proANP, NT-proBNP, adipokines, endothelin-1 (ET-1), angiogenic growth factors, and the proinflammatory cytokine, interleukin-6 (IL-6). Results. The level of cNT-proBNP was significantly higher in patients of the FC III CHF+DM2 group than in patients with FC III CHF without type 2 DM. Patients with CHF+DM2 had the highest level of cET-1, which was associated with LV diastolic dysfunction (DD). In patients with CHF+DM2. hyperleptinemia and hypoadiponectinemia were associated with obesity. The CHF+DM2 group had the highest level of cHGF, which depended on blood glucose control in type 2 DM. The highest levels of circulating resistin were observed in patients with CHF+DM2 and with DM2 without CHF. Increased levels of cIL-6 were found in patients with CHF and CHF+DM2. Conclusion. The prognostic value of cMR-proANP and cNT-proBNP can be assessed only in a prospective study. Levels of cET-1, cAN, cHM-AN, leptin, resistin, angiogenic growth factors cHGF, cVEGF, angiopoietin-1 and the proinflammatory cytokine IL-6 can be candidate markers associated with metabolic disorders in patients with post-infarction CHF, which should be tested in prospective studies.
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Kochegura T.N., Makarevich P.I., Ovchinnikov A.G. et al. Circulating factors associated with metabolic disorders in patients with post-infarction heart failure. Russian Heart Failure Journal. 2013;14 (4):191-199

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