ANALYSIS OF INSTRUMENTAL EXAMINATIONS IN SILENT MYOCARDIAL ISCHEMIA AND ANGINA PECTORIS PATIENTS WITH AND WITHOUT DIABETES MELLITUS

• Published in: The Bulletin of Contemporary Clinical Medicine Vol. 17; no. 4; pp. 30 - 39
• Main Authors: ABDRAHMANOVA, ALSU I., TSIBULKIN, NICOLAY A., AMIROV, NAIL B.
• Format: Journal Article
• Language: English
• Published: 01.08.2024
• ISSN: 2071-0240; 2079-553X
• DOI: 10.20969/VSKM.2024.17(4).30-39

Introduction. Diabetes mellitus may be one of factors in the development of silent myocardial ischemia. Prevalence of silent myocardial ischemia in diabetes mellitus patients ranges within 6-50%. Aim of this study is to analyze the instrumental examinations in patients with silent myocardial ischemia and with angina pectoris (control group), with and without type 2 diabetes mellitus. Materials and Methods. A total of 607 patient records were analyzed. Coronary angiography and echocardiography results were evaluated. Statistical analysis included parametric and nonparametric criteria, significant difference at p<0.05. Results and Discussion. In patients with diabetes mellitus, coronary stenting was less frequent in the silent myocardial ischemia group, while in those without diabetes mellitus, both stenting and bypass were less frequent in the silent myocardial ischemia group comparing to the control group. In most left ventricle segments, there was no difference in coronary blood flow between the silent myocardial ischemia group and the control group, regardless of diabetes mellitus. In patients with diabetes mellitus, coronary stenosis is higher regardless of silent myocardial ischemia. Anterior and septal lv walls do not differ in segmental contractility in the silent myocardial ischemia group and in the control group regardless of diabetes mellitus. Inferior and lateral walls have decreased contractility in the control group: In basal and medial segments of inferior wall in patients with diabetes mellitus; and in all apical segments and lateral wall in patients without diabetes mellitus. In inferior lv wall of the control group patients, silent myocardial ischemia negates possible negative effect of diabetes mellitus exerted by coronary atherosclerosis. Reduced contractility in almost all apical and medial segments is not related to silent myocardial ischemia or diabetes mellitus, they do not change segmental contractility in this area. In patients with diabetes mellitus, segmental contractility was better in basal segments in the silent myocardial ischemia group. Conclusion. Silent myocardial ischemia is a special property of myocardium, which may possibly have an adaptive function.