A COMPARATIVE ASSESSMENT OF THE EFFECT OF MINERALOCORTICOID RECEPTOR ANTAGONISTS ON CHANGES IN GALECTIN-3 AND MMP-1 FIBROSIS MARKERS IN PATIENTS WITH CHRONIC CARDIAC FAILURE COMBINED WITH TYPE 2 DIABETES MELLITUS WITH MANIFESTATIONS OF MYOCARDIUM DYSSYNCHRONY

doi:10.26565/2227-6505-2016-32-07

T. A. Rudenko Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

DOI: https://doi.org/10.26565/2227-6505-2016-32-07

Keywords: interstitial collagen volume faction, chronic cardiac failure, myocardium dyssynchrony, galectin 3, matrix metalloproteinase 1

Abstract

A comparative assessment of the effect of mineralocorticoid receptor antagonists on changes in galectin 3 and matrix metalloproteinase 1 fibrosis markers has been carried out on 106 examinations (average age (69 + 10.37) years) with type 2 DM and CCF of ischemic nature of I-IV FC according to NYHA with retained systolic function of the left ventricle and manifestations of myocardium dyssynchrony.

All the patients were divided into 3 groups depending on the intake of mineralocorticoid receptor antagonists. Myocardium dyssynchrony was assessed according to the generally accepted technique; the volume faction of interstitial collagen was measured using the formula of J. Shirani et al.; galectin-3 and matrix metalloproteinase-1 levels – using the immunoenzyme method according to the manufacturer’s manual. The data was processed using the methods of parametric and non-parametric statistics. It was discovered that the myocardium dyssynchrony development percentage in the group of patients not taking mineralocorticoid receptor antagonists was higher than in the group of patients taking spironolactone or eplerenone. An increase in fibrosis marker levels was shown in the spironolactone intake group compared with the group of patients taking eplerenone. Mineralocorticoid receptor antagonist intake requires blood potassium level control and case monitoring of manifestations of dyssynchrony and myocardial fibrosis.

Downloads

Download data is not yet available.

Author Biography

T. A. Rudenko, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

street Amosov, 58, Kharkiv, Kharkiv, 61000

References

Update on aldosterone antagonists use in heart failure with reduced left ventricular ejection fraction. Heart Failure Society of America Guidelines Committee. / [J. Butler J, J. A. Ezekowitz JA, S. P. Collins SP et al.]. // J Card Fail. – 2012. – № 18. – P. 265–281.

Ezekowitz JA J. A. Aldosterone blockade and left ventricular dysfunction: a systematic review of randomized clinical trials. / J. A. Ezekowitz JA, F. A. McAlister FA. // Eur Heart J. – 2009. – № 30. – P. 469–477.

The QTc intervalduration class and clinical features of patients with pacemakers in the acute postoperative period / M. S. Maltseva, D. E. Volkov, D. A. Lopin // The Journalof Kharkiv V. N. Karazin` National University, Series «Medicine», Issue 25. – 2013. – № 1044. – P. 29–36.

Impact of mineralocorticoid receptor antagonists on changes in cardiac structure and function of left ventricular dysfunction: a meta-analysis of randomized controlled trials. / [X. Li, Y. Qi, Y. Li та ін.]. // Circ Heart Fail. – 2013. – № 6. – P. 156–165.

Rudenko T. A. Role of glycaemia level in the development of interstitial collagen in patients with coronary heart disease and type 2 diabetes/ T.A.Rudenko. // Journal of V. N. Karazin` KhNU. – 2015. – № 30. – P. 30 –33.

Cost effectiveness of eplerenone in patients with chronic heart failure / Z.Ademi, K. Pasupathi, H. Krum, D. Liew. // Am. J. Cardiovasc.Drugs. – 2014. – № 14. – P. 209–216.

ESC Guidelinesfor the diagnosis and treatment of acute and chronic heart failure2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology.Developed in collaboration with the Heart Fai / [J. J. McMurray, S. Adamopoulos, S. D. Anker та ін.]. // Eur. Heart J. – 2012. – № 33. – P. 1787–1847.

ACCF/AHA Guideline forthe Management of ST-Elevation Myocardial Infarction. A Report ofthe American College of Cardiology Foundation/American Heart Association. Task Force on Practice Guidelines / [P. O’Gara, F. Kushner, D. Ascheim та ін.]. // Circulation. – 2013. – № 127. – P. 362–425.

2013 ACCF/AHA guidelinefor the management of heart failure: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines / [C. W. Yancy, M. Jessup, B. Bozkurt та ін.]. // J. Am. Coll. Cardiol. – 2013. – № 62. – P. 147–239.

Mechanical dyssynchrony and deformation imaging in patients with functional mitral regurgitation / [R. Isabella, M. Claudia, S. Stefano та ін.]. // World J Cardiol. – 2016. – № 8. – P. 146–162.

Shirani J. Usefulness of the Electrocar diagram and Echocar diagram in predicting the amount of inter stitial myocardial cjllagen in endomyocardial biopsy specimens of patients with chronic heart failure / J. Shirani, R. Pick, Y. Quo. // Am. J. Cardiol. – 1992. – № 69. – P. 1502.

Aroor A. R. The role of tissue Renin Angiotensin aldosterone system in the development of endothelial dysfunction and arterial stiffness / A. R. Aroor, V. G. Demarco. // Front. Endocrinol. – 2013. – № 4. – P. 161.

Mineralo corticoid receptor antagonism prevents the electrical remodeling that precedes cellular hypertrophy after myocardial infarction / [E. Perrier, B. G. Kerfant, N. Lalevee та ін.]. // Circul. – 2004. – № 110. – P. 776–783.

Effects of aldosterone on the gap junction channel protein connexin 43 in neonatal rat ventricular myocytes / [S. Suzuki, T. Ohkusa, T. Sato та ін.]. // J. Cardiac. Fail. – 2006. – № 12. – P. 165.

Natriuretic peptides: molecular biology, pathophysiology and clinical implications for the cardiologist / [R. D’Alessandro, D. Masarone, A. Buono та ін.]. // FutureCardiol. – 2013. – № 4. – P. 519–534.

Mediators of perivascular inflammation in the left ventricle of renovascular hypertensive rats / [A. Nicoletti, C. Mandet, M. Challah та ін.]. // Cardiovasc. Res. – 1996. – № 31. – P. 585–595.