«ОЦЕНКА ПАРАМЕТРОВ ЦЕНТРАЛЬНОЙ ГЕМОДИНАМИКИ У ПАЦИЕНТОВ С НЕЙРОИШЕМИЧЕСКОЙ ФОРМОЙ СИНДРОМА ДИАБЕТИЧЕСКОЙ СТОПЫ АССОЦИИРОВАННО С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА»
Keywords:
diabetic foot syndrome, coronary heart disease, central hemodynamicsAbstract
The purpose of the study is to study the results of ultrasound dopplerography of the heart in patients with a neuroichemic form of diabetic foot syndrome (DFS) associated with coronary heart disease (CHD)
Material and research methods. During the 2021-2022, 70 patients with the DFS of a neurohemic form were examined by us during 2021-2022. Patients were distributed to 4 groups:
1 g - patients DM 2 diabetes and neuroichemic form of the DFS and CHD - 21 patients,
Group 2 - patients with DM 2 and neuroichemic form of DFS without coronary heart disease - 18 patients,
Group 3-patients with DM 2 and neuroichemic form of DFS, CPS and discirculatory encephalopathy 2-3 tbsp-16 patients.
Group 4 - Persons with CHD without breaking carbohydrate metabolism - 15 patients.
Healthy volunteers (n = 20) compiled a control group.
All patients of the 4th groups made up the main group. All of them were subjected to general clinical, biochemical (glycemia, glycated hemoglobin, bird, ALT, AST, bilirubin, urea, creatinine blood), hormonal (Iri, C -peptide, etc.) and instrumental methods of research -ultrasonic dopplerography of the vessels of the brain, lower limbs, ECG, Echo-ECG, bacteriological analysis of the separated from the wound, as well as statistical methods.
Results. The KDO LV KDO in patients with the main group with DFS and CHD (107.1 ± 5.21*) was significantly lower than in the control group (120.5 ± 2.57ml; p <0.05). The average CSR of the LV in patients was also significantly lower (34.04 ± 2.61*) than in groupcontrol (52.5 ± 1.33ml; p <0.05). Indexed by KDO and CSO LV, in patients with DFS and CHD had statistically significant differences in comparison with the data of the control group (p <0.05).
Conclusions. 1. Changes in hemodynamics on echocardiography are observed before the appearance of the CHF clinic. 2. EchoCG changes are most pronounced in patients of group 1 with DM2 and neuroichemic form of the DFS and CHD.
References
Jean-Louis Schlienger 1 [Type 2 diabetes complications] Presse Med. 2013 May;42(5):839-48. Doi: 10.1016/j.lpm.2013.02.313. Epub 2013 Mar 23.
Isa Dietrich 1 2, Gustavo Arruda Braga 3, Fernanda Gomes de Melo 3, Ana Carolina Calmon da Costa Silva Silva 3The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review Curr Atheroscler Rep. 2017 Oct 2;19(11):44. Doi: 10.1007/s11883-017-0680-z.
Barbara Bohn 1 2, Arthur Grünerbel 3, Marcus Altmeier 4, Carsten Giesche 5, Martin Pfeifer 6, Diabetic foot syndrome in patients with diabetes. A multicenter German/Austrian DPV analysis on 33 870 patients //Diabetes Metab Res Rev. 2018 Sep;34(6):e3020.doi: 10.1002/dmrr.3020. Epub 2018 Jun 1.
Antonino Tuttolomondo,1 Carlo Maida,1 and Antonio Pinto1Diabetic Foot Syndrome as a Possible //Cardiovascular Marker in Diabetic Patients Ъreview Article | Open Access Volume 2015 |Article ID 268390 | https://doi.org/10.1155/2015/268390
American Diabetes Association, “Consensus development conference on diabetic foot wound care: 7-8 April 1999, Boston, Massachusetts. American Diabetes Association,” Diabetes Care, vol. 22, no. 8, pp. 1354–1360, 1999.View at:
R. E. Pecoraro, G. E. Reiber, and E. M. Burgess, “Pathways to diabetic limb amputation: basis for prevention,” Diabetes Care, vol. 13, no. 5, pp. 513–521, 1990.
M. P. Khanolkar, S. C. Bain, and J. W. Stephens, “The diabetic foot,” QJM, vol. 101, no. 9, pp. 685–695, 2008.
G. E. Reiber, “Epidemiology of foot ulcers and amputations in the diabetic foot,” in The Diabetic Foot, J. H. Bowker and M. A. Pfeifer, Eds., pp. 13–32, Mosby, St. Louis, Mo, USA, 2001.
S. E. Moss, R. Klein, and B. E. K. Klein, “The prevalence and incidence of lower extremity amputation in a diabetic population,” Archives of Internal Medicine, vol. 152, no. 3, pp. 610–616, 1992.
S. D. Ramsey, K. Newton, D. Blough et al., “Incidence, outcomes, and cost of foot ulcers in patients with diabetes,” Diabetes Care, vol. 22, no. 3, pp. 382–387, 1999.
C. A. Abbott, L. Vileikyte, S. Williamson, A. L. Carrington, and A. J. M. Boulton, “Multicenter study of the incidence of and predictive risk factors for diabetic neuropathic foot ulceration,” Diabetes Care, vol. 21, no. 7, pp. 1071–1075, 1998.
D. P. Walters, W. Gatling, M. A. Mullee, and R. D. Hill, “The distribution and severity of diabetic foot disease: a community study with comparison to a non-diabetic group,” Diabetic Medicine, vol. 9, no. 4, pp. 354–358, 1992.View at:
P. LeQuesne, N. Parkshouse, and I. Faris, “Neuropathy,” in The Management of the Diabetic Foot, I. Faris, Ed., p. 41, Churchill Livingstone, Edinburgh, Scotland, 2nd edition, 1991.
G. E. Reiber, D. G. Smith, L. Vileikyte et al., “Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings,” Diabetes Care, vol. 22, no. 1, pp. 157–162, 1999.
R. D. Abbott, F. N. Brand, and W. B. Kannel, “Epidemiology of some peripheral arterial findings in diabetic men and women: experiences from the Framingham Study,” The American Journal of Medicine, vol. 88, no. 4, pp. 376–381, 1990.
C. Daousi, I. A. MacFarlane, A. Woodward, T. J. Nurmikkot, P. E. Bundred, and S. J. Benbow, “Chronic painful peripheral neuropathy in an urban community: a controlled comparison of people with and without diabetes,” Diabetic Medicine, vol. 21, no. 9, pp. 976–982, 2004.
A. Pinto, A. Tuttolomondo, D. Di Raimondo et al., “Cardiovascular risk profile and morbidity in subjects affected by type 2 diabetes mellitus with and without diabetic foot,” Metabolism, vol. 57, no. 5, pp. 676–682, 2008.View at:
N. A. Roper, R. W. Bilous, W. F. Kelly, N. C. Unwin, and V. M. Connolly, “Excess mortality in a population with diabetes and the impact of material deprivation: longitudinal, population based study,” British Medical Journal, vol. 322, no. 7299, pp. 1389–1393, 2001.
W. B. Kannel and D. L. McGee, “Diabetes and cardiovascular disease: the Framingham study,” The Journal of the American Medical Association, vol. 241, no. 19, pp. 2035–2038, 1979.
J. S. Rana, M. Nieuwdorp, J. W. Jukema, and J. J. P. Kastelein, “Cardiovascular metabolic syndrome—an interplay of, obesity, inflammation, diabetes and coronary heart disease,” Diabetes, Obesity and Metabolism, vol. 9, no. 3, pp. 218–232, 2007.
A. Pinto, A. Tuttolomondo, D. di Raimondo et al., “Ischemic stroke in patients with diabetic foot,” International Angiology, vol. 26, no. 3, pp. 266–269, 2007.View at:
A. Tuttolomondo, S. La Placa, D. Di Raimondo et al., “Adiponectin, resistin and IL-6 plasma levels in subjects with diabetic foot and possible correlations with clinical variables and cardiovascular co-morbidity,” Cardiovascular Diabetology, vol. 9, article 50, 2010.
H. Sell and J. Eckel, “Chemotactic cytokines, obesity and type 2 diabetes: in vivo and in vitro evidence for a possible causal correlation?” Proceedings of the Nutrition Society, vol. 68, no. 4, pp. 378–384, 2009.
J.-P. Bastard, M. Maachi, C. Lagathu et al., “Recent advances in the relationship between obesity, inflammation, and insulin resistance,” European Cytokine Network, vol. 17, no. 1, pp. 4–12, 2006.
