Endothelial dysfunction markers, functional and structural changes in the myocardium and platelets of patients with type 2 diabetes mellitus and cardiovascular autonomic neuropathy

Abstract

The aim of this study was to investigate the platelet aggregation and their ultrastructural organization, concentration of 6-keto-prostaglandin F1 (6k-PGF1) and  thromboxane В2 (TXB2) in blood and urine, the content of endothelin-1 (ET-1) and N-terminal brain natriuretic peptide fragment (NT-proBNP) in blood as well as functional and structural changes in the myocardium of patients with type 2 diabetes mellitus (T2DM) and cardiovascular autonomic neuropathy (CAN). It has been  established that subclinical - and especially clinical CAN stages - are characterized by a significant increase in platelet aggregation velocity, pathophysiological  changes in their ultrastructure, are accompanied by an increase in TXB2 concentration and a decrease in 6k-PGF 1 in blood and urine. In patients with T2DM and  subclinical CAN a significant increase in ET-1 concentration was found, which can be considered as an early sensitive marker of CAN development. The observed  increase in NT-proBNP may indicate the presence of subclinical CAN; it correlates with the development and/or CAN progression, and is significantly and  independently associated with an increased left ventricular myocardial mass and index.