Diabetes Mellitus a Chronic Heart Failure
Špinar J.1, Vítovec J.2
1II. interní klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Miroslav Souček, CSc.2I. interní kardio-angiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc. |
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Summary:
Diabetes mellitus is one of the significant risk factors for many cardiovascular diseases. Diabetes
mellitus is 3-4 times more frequent in patients with heart failure compared to patients without
heart failure. Prognosis of patients with heart failure and diabetes mellitus is worse than prognosis
of non-diabetic patients with the same left ventricular dysfunction. The term diabetic cardiomyopathy
refers to a relation between diabetes mellitus and heart disease, but it probably isn’t
a separate morphology unit. In treatment of patients with diabetes mellitus general rules apply to
heart failure management. The effect of ACE inhibitors was in majority of studies stronger in
diabetics than in non-diabetics, the effect of beta blockers was comparable or smaller. Treatment
is based on good compensation of metabolic parameters, blood pressure, titration of ACE inhibitors
into recommended doses, and an optimal dose of a beta blocker. Type II diabetics with heart
failure will, due to decreased resorption and metabolism, need insulin more often than diabetics
without heart failure.
Key words:
Diabetes mellitus – Heart failure - Prognosis - Hypertension - Ischemic heart disease
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