ASSESSMENT OF SITAGLIPTIN INFLUENCE ON ARTERIAL WALL STIFFNESS, RENAL FUNCTION AND RENAL CIRCULATION IN CARDIOVSCULAR PATIENTS WITH DECOMPENSATED TYPE 2 DIABETES

Aim. To study dynamics of stiffness parameters in various type arteries, renal function and renal circulation in arterial hypertension (AH) and ischemic heart disease (CHD ) with decompensated 2 type diabetes mellitus (DM2) on the sitagliptin therapy during 24 weeks.Material and methods. Totally 30 patients included, with decompensated DM2 (HbA1c >7%) and AH, most having also CHD. The dynamics of carbohydrate and lipid metabolisms were assessed, arterial wall stiffness in various structural and functional types, renal function and renal circulation at the background of sitagliptine therapy during 24 weeks.Results. There was no dynamics by the parameters of arterial wall stiffness in various types of arteries, as in renal function and renal circulation among the patients in sitagliptin (n=15) and comparison (n=15) groups. However in those achieved compensation of DM2 on sitagliptin (n=8) we found a decrease of stiffnes index β of brachial artery (muscular type) by 37% from baseline (p<0,01). There was no dynamics of stiffness in muscle-elastic or muscular types of arteries.Conclusion. In patients with hipertension disease and ischemic heart disease with DM2 on glucoselowering therapy there was no dynamics by the parameters of aortic, common caritid artery stiffness and renal circulation during 6 months followup. However on the therapy by dipeptidilpeptidase-4 inhibitor (sitagliptin) during 6 months and compensation of DM2 (HbA1c <7%) there was a decrease of brachial artery stiffness (muscular type)

IMPACT OF LEVOSIMENDAN ON RENAL FUNCTION IN COMPLEX TREATMENT OF ACUTE DECOMPENSATED HEART FAILURE

Background. Levosimendan infusion can be used in the treatment of patients with acute decompensated heart failure (ADHF) with a reduction in cardiac output and signs of severe congestion/pulmonary edema.Aim. To study impact of levosimendan on renal function in patients with ADHF with reduced systolic function.Material and methods. The study was a prospective, randomized trial. We enrolled 30 men (age 62.5 [55.8-69.3] years) hospitalized with ADHF with reduced systolic function (left ventricular ejection fraction <40%), increased level of brain natriuretic peptide (BNP>500 pg/mL) and systolic blood pressure >125 mmHg. All patients were randomized into 2 groups of 15 people each. In the first group, the patients received an intravenous infusion of levosimendan 0.1 μg/kg/min for 24 hour added to standard therapy. The second group received standard therapy.Results. 24-hour levosimendan infusion significantly increased the glomerular filtration rate levels from 65.4 [45.2-99.2] mL/min/1.73m2 at baseline to 79.0 [66.3-93.1] mL/min/1.73m2 at discharge (p= 0.011), greatly decreased serum creatinine from 1.17 [0.90-1.55] mg/dL at baseline to 1.01 [0.89-1.14] mg/dL at discharge (p = 0.009) and blood urea nitrogen and at the same time improved renal blood flow in patients with ADHF while there were no clinically significant changes in the studied parameters in the standard therapy group.Conclusion. Levosimendan had a positive effect on renal function in patients with ADHF with reduced systolic function