VOZMOZhNOSTI DIBIKORA V KORREKTsII METABOLIChESKIKh I SOSUDISTYKh NARUShENIY U BOL'NYKh KhRONIChESKOY SERDEChNOY NEDOSTATOChNOST'Yu I SAKhARNYM DIABETOM 2 TIPA

The article presents the results of evaluation of effect of taurine in the combined treatment of chronic heart failure (CHF) on carbohydrate and lipid metabolism, insulin resistance, heart rate variability, systolic and diastolic function of the heart and vascular elastic properties and parameters of microcirculation (MC). The high frequency of heart failure and type 2 diabetes mellitus (DM2), poor prognosis and poor quality of life determine the relevance of the issue of selection of optimal therapy. In diabetes, prevention of target organ damage, including microcirculatory vessels and large arteries, is one of the main goals of treatment. The study included 60 patients of both sexes in the early postinfarction period with functional class (FC) II-III CHF (NYHA) and concomitant DM2. All patients were randomized into two groups of 30 people : Group 1 has received standard therapy of heart failure and standard antidiabetic therapy, and Group 2 has additionally received taurine at the dose of 500 mg twice a day. The effects of 16-week treatment with taurine on FC heart failure, structural and functional cardiac parameters, carbohydrate and lipid metabolism, heart rate variability and MC, elastic properties of the main vessels in CHF patients with concomitant DM2 were evaluated. Inclusion of taurine in the combined treatment of CHF and DM2 has statistical trend to reduce the blood levels of brain natriuretic propeptide, significantly increase the left ventricular ejection fraction, decrease the fasting blood glucose levels and glycosylated hemoglobin levels, decrease the insulin resistance, reduce the LDL and triglyceride levels, leading to normalization of the autonomic cardiac function in particular reduces the number of patients with hypersympathicotonia , promotes clinically significant reduction in stiffness of the vascular wall of the large arteries and significantly improves endothelial function. Against the background of use of taurine, statistically significant increase in the proportion of normocirculation hemodynamic type of microcirculation in patients with CHF and DM2 occurs, attributable to the reducing of the occurrence of spastic type of hemodynamics. Thus, the inclusion of taurine in the combined treatment of patients with CHF and DM2 is justified in early postinfarction period.

diabetes mellitus, chronic heart failure, microcirculation, the elastic properties of blood vessels, taurine