Markers of heart failure associated with conditions of prolonged stress and the possibility of their correction with modern hypoglycemic drugs

Abstract

Abstract. It is known that acute and chronic stress often affects the cardiovascular system with the formation of heart failure in the future. The monitoring of the possible development of cardiovascular disorders in patients with type 2 diabetes mellitus (T2DM), who represent a group at risk of these complications associated with various neurological and cardiovascular diseases, including heart failure (HF). T2DM is associated with worse clinical status and increased all-cause and cardiovascular mortality in HF patients with both reduced and preserved ejection fraction (EF) compared with HF patients without diabetes. For its part, a decrease in EF is an independent predictor of fatal and non-fatal clinical outcomes in T2DM patients. The most important causes of HF in T2DM are coronary heart disease, arterial hypertension, and direct harmful effects of T2DM on the myocardium. The combination of these disorders with the features of changes in the left ventricle EF determines one of the 3 possible phenotypes of HF in patients. Thelaboratory markers of HF play an important role in the differential diagnosis of the HF phenotypes, along with clinical and cardiographic signs. The determination of these biomarkers in recent years has opened a new era in the field of diagnosis and monitoring of cardiac pathology, which is becoming increasingly widespread within the framework of the newest scientific direction – metabolomics (or metabolic phenotyping). Estimating the quantitative content of these biomarkers makes it possible to create an individual picture of the mechanisms of metabolic disorders and to determine ways of their correction. ways of their correction. Evidence from clinical trials
identifies 3 main biomarkers that can be considered individually or in combination: NT-proBNP, SТ2 peptide, and insulin-like growth factorbinding protein 7 (IGFBP -7). The purpose of this review is to analyze the significance of the levels of known cardiovascular biomarkers in the treatment of HF in patients with T2DM and the changes in the levels of these biomarkers during the treatment of patients, as well as to determine the impact on the risk of complications, in particular, when using modern antidiabetic drugs: sodium-dependent glucose cotransporter inhibitor type 2 (SGLT2) and glucagon-like peptide-1 (ar-GLP-1) receptor agonists.