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The article identified gender and age characteristics of cardiac remodeling in patients with postinfarction cardiosclerosis, diabetes mellitus (DM) type 2 and obesity.
To this end, we have examined 295 patients with postinfarction cardiosclerosis. Gender and age characteristics of cardiac remodeling in 215 patients with postinfarction cardiosclerosis, DM type 2 and obesity were compared with that in patients who did not have diabetes and obesity (comparison group (n = 80)). All patients with postinfarction cardiosclerosis were divided into groups depending on the presence of DM type 2 (first group (n = 68)), obesity (second group (n = 76)) and their combination (third group (n = 71)). Patients of all groups were matched by age (64.38 ± 1.08; 64.87 ± 1.98; 65.13 ± 1.43 and 63.47 ± 1.28 years, respectively). Diagnosis verification was carried out on the basis of the existing criteria. All patients underwent general clinical and instrumental examination. Echocardiographic studies were performed by the standard procedure of H. Feigenbaum on ultrasonic device RADMIR (Ultima PRO 30, Kharkiv, Ukraine).
Gender analysis showed a probable increase in the sizes of the left ventricle and left atrium on the background of more significant decrease of systolic function in men with postinfarction cardiosclerosis, DM type 2 and obesity compared with women, regardless of age. Elderly patients experienced the same changes as middle-aged patients. In all patients we have detected violations in geometric adaptation, of them concentric remodeling was revealed predominantly in females, in surveyed males we have noticed more often eccentric left ventricular remodeling.
Thus, in women valid factors determining the severity of left ventricular myocardium damage and the course of chronic heart failure, against previous myocardial infarction, are DM type 2, overweight and predominance of «favorable» concentric remodeling of the left ventricle with preserved systolic function. Whereas in men myocardial remodeling has a less favorable course with increased sizes of the left ventricle and left atrium on the background of more significant decrease of systolic function.
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