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[Myocardial and vascular impairment in diabetes mellitus]
Insights
Patients with diabetes mellitus and ischemic heart disease exhibit altered microcirculation, including thickened vascular walls and impaired endothelial function. These changes contribute to cardiovascular complications in diabetic patients.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pathology
Context:
- Diabetes mellitus (DM) is a significant risk factor for ischemic heart disease (IHD).
- Understanding the interplay between metabolic disorders and cardiovascular complications in DM is crucial for patient management.
- Previous research suggests potential links between hormonal and metabolic dysregulation and IHD in diabetic populations.
Purpose:
- To investigate the relationship between ischemic heart disease (IHD) and hormonal/metabolic disorders in patients with diabetes mellitus.
- To assess microcirculatory changes and vascular wall characteristics in diabetic patients with and without IHD.
Summary:
- Microscopic examination of endomyocardial biopsies revealed significant morphological alterations in myocardial vessels of diabetic patients.
- Vascular walls were thickened and homogenized, with edema and destruction of endothelyocytes and basal membrane enlargement.
- Impaired antithrombogenic activity of the vascular wall was observed, characterized by platelet hypersensitivity, active arachidonic acid metabolism, and reduced prostacyclin endothelial activity.
Impact:
- The findings highlight microcirculatory dysfunction as a key contributor to IHD in diabetes mellitus.
- This research provides insights into the pathomechanisms underlying cardiovascular complications in diabetic patients.
- Understanding these vascular changes can inform the development of targeted therapeutic strategies for preventing and managing IHD in diabetes.
Aim:
To study relations between ischemic heart disease (IHD) and hormonal and metabolic disorders in patients with diabetes mellitus and IHD.
Material And Methods:
Cuff test was used to study functional activity of the vessels. Platelet aggregation, prostacyclin, antithrombin III were studied in 168 healthy subjects, diabetes mellitus (DM) patients (n = 98) and DM type 2 patients (n = 118).
Results:
Microscopic examinations of the myocardium (endomyocardial biopsy) were made and the results were compared to antithrombogenic activity of vascular wall in DM. Myocardial vessels in the patients have undergone morphological alterations. Antithrombogenic activity of the vessels in DM patients was studied under compression.
Conclusion:
Microcirculation was found changed: vascular walls were thick and homogenized, endothelyocytes underwent edema and destruction with enlargement of the basal membrane. Platelet hypersensitivity was proved in DM as well as more active metabolism of arachidonic acid, low prostacyclin endothelial activity.