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PARAMETERS OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH HYPERTENSION DISEASE WITH CONCOMITANT TYPE 2

Olexandr Bilovol1, Iryna Knyazkova1, Inna Dunaieva1

  • 1KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|August 25, 2023
PubMed

Insights

This study investigated how Eplerenone and Trimetazidine affect left ventricular diastolic function in patients with hypertension and type 2 diabetes. Treatment improved myocardial relaxation and reduced heart failure progression and cardiovascular risks.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Hypertension (HT) and type 2 diabetes mellitus (T2DM) are significant risk factors for cardiovascular disease.
  • Diastolic dysfunction is a common complication in patients with comorbid HT and T2DM.
  • Understanding the impact of specific pharmacological interventions on diastolic function is crucial for managing these patients.

Purpose of the Study:

  • To evaluate left ventricular (LV) diastolic function parameters in patients with HT, with and without T2DM.
  • To assess the effects of a 3-month combined treatment regimen of Eplerenone (50 mg/day) and Trimetazidine (80 mg/day) on LV diastolic function.
  • To compare outcomes between patients with HT alone and those with concomitant HT and T2DM.

Main Methods:

  • A study involving 50 patients (aged 45-54) with stage II HT, divided into two groups: HT only (n=25) and HT with T2DM (n=25).
  • A control group of 20 healthy individuals was included for comparison.
  • Patients received a 3-month treatment course with Eplerenone and Trimetazidine; LV diastolic function parameters, including left atrial volume index (LAVI), were analyzed before and after treatment.

Main Results:

  • Initial analysis showed higher left atrial volume index (LAVI) in patients with HT and T2DM compared to HT alone and the control group, suggesting progressive functional changes.
  • These changes are attributed to cardiomyocyte kinetic alterations driven by metabolic and hemodynamic disturbances in comorbid pathology.
  • While differences were not statistically significant at baseline, the trend indicated a greater burden in the T2DM group.

Conclusions:

  • A three-month treatment with Eplerenone and Trimetazidine appears to enhance myocardial relaxation during diastole in both patient groups.
  • The combined therapy demonstrated a positive effect in reducing the progression rate of heart failure.
  • This treatment regimen contributed to a significant reduction in overall cardiovascular risks for patients with HT and T2DM.
Abstract

Keywords:
type 2 diabetes mellitusTrimetazidinediastolic flowhypertensionEplerenonecomorbid pathology

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