Cardiac arrhythmias in patients with type 2 diabetes mellitus

Abstract

Introduction. The contribution of type 2 diabetes mellitus (type 2 diabetes) and cardiovascular diseases (CVD) to the increase in disability and mortality rates worldwide continues to grow steadily. Currently, the main focus is on the problem of atherosclerotic cardiovascular diseases (ACCD) in DM, while the manifestations of cardiac arrhythmias (LDC) in conditions of carbohydrate metabolism disorders have not been sufficiently studied.The purpose of the study. To analyze and compare laboratory, instrumental and objective indicators in patients with type 2 diabetes mellitus (type 2 diabetes mellitus) and without, who have a history of cardiac arrhythmias (LDC).Materials and methods. 103 patients with LDC (52 men and 51 women) were examined. 2 groups were formed: the main group – patients with LDC and type 2 diabetes (n=51) (group 1), the control group –  patients with LDC without diabetes (n=52) (group 2). A comparative analysis of laboratory-instrumental and clinical-anamnestic data in the groups was performed. Statistical data processing was performed using the statistical software package "Excel" ("Microsoft"), the program "Statistica 10" ("Statsoft Inc"). The value of p <0.05 was taken as the significance level. The reliability of the differences between the groups was determined using the Mann-Whitney U-test, and the correlation analysis was carried out using the Spearman criterion.Results. The average age of the general group was 67[18;97] years, patients with type 2 diabetes 69 [53;93] years, patients without diabetes 65 [18;97] years. According to the performed regression analysis, it was found that DM in patients was associated with the detection of atrial fibrillation (OR 2.69 (95% CI 1.076;6.71), p=0.034), in particular, its constant form (p=0.025, coefficient. Kramer's V = 0.33), as well as with the presence of supraventricular extrasystole (NJES) (OR 0.235 (95%CI 0.09;0.59), p=0.002, coefficient. Kramer's V = 0.311). At the same time, there was no significant association of DM with the presence of paroxysmal and persistent forms of atrial fibrillation, atrial flutter (TP), BLNPG, AV block, CA block, ventricular extrasystole, supraventricular tachycardia (NVT) and SSSI.When evaluating the functional parameters of the myocardium according to Echo-K G data, it was found that in the main group, compared with the control group, significant (34% vs. 27%) and pronounced (18% vs. 6%) pulmonary hypertension were more common, but the difference was not statistically significant (p>0.05).When assessing the structural and geometric parameters of the myocardium, it was found that concentric myocardial hypertrophy was more common in the main group (22% vs. 15%), and in the control group –  concentric myocardial remodeling (14% vs. 25%), (p>0.05).Conclusions. DM is a significant risk factor for a more severe course of LDC, in particular atrial fibrillation and supraventricular ectopias. In this regard, it is of fundamental importance to control carbohydrate metabolism and prevent risk factors for cardiovascular diseases in order to preserve the basic functions of the myocardium and improve the quality of life of patients with diabetes mellitus.