CARDIAC SHOCK WAVE THERAPY IN THE TREATMENT OF ISCHEMIC CARDIOMYOPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
DOI:
https://doi.org/10.32782/2226-2008-2024-3-5Keywords:
ischemic cardiomyopathy, coronary heart disease, diabetes mellitus, cardiac shock wave therapyAbstract
Introduction. Heart failure (HF) remains one of the greatest problems today. One of the causes of HF is ischemic cardiomyopathy (ICM). The prognosis is particularly disappointing and the most difficult to treat patients with concomitant diabetes mellitus (DM) due to the effect of hyperglycemia on vessels of different caliber and damage to nerve endings. Cardiac shock wave therapy (CSWT) is one of the most promising noninvasive means of revascularization in the area of chronic myocardial ischemia. The aim of the study is to evaluate the effectiveness of CSWT in the complex treatment of ICM in patients with type 2 diabetes. Materials and methods. The study was conducted at the Regional Center for Cardiac Surgery of Odesa Regional Clinical Hospital (Odesa) in 2012–2022. 100 patients with ICM and type 2 DM were randomly divided into 2 groups. Patients in the first group (n=49) received standard therapy following current protocols. The second group (n=51) of patients additionally received CSWT complementary to standard therapy. The treatment results were evaluated at the end of the CSWT course, after 6 months, 1 year, and 2 years. Results. The additional use of CSWT in patients with ICM with diabetes mellitus, in whom standard therapy was insufficient, showed an improvement in the quality of life and adherence to treatment. CSWT improves the contractile function of the heart, as evidenced by an increase in the ejection fraction. CSWT has a direct short-term and indirect long-term effect on the coronary vessels, in particular the microcirculatory part. Conclusions. 1. The clinical effect of CSWT in patients with ischemic cardiomyopathy and type 2 diabetes mellitus consists in improvement of LV systolic function, increase in exercise tolerance, and reduction of heart failure severity. 2. CSWT has shown high clinical efficacy and can be recommended for use in patients with ischemic cardiomyopathy on the background of type 2 diabetes mellitus.
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