Zatajivanje srca u bolesnika sa šećernom bolešću

master's thesis

• Title (english): Heart failure in patients with diabetes mellitus
• Author: Katarina Mihaljević
• Mentor: Venija Cerovečki Nekić (mentor)
• Committee member: Ksenija Kranjčević (predsjednik povjerenstva)
• Committee member: Zlata Ožvačić Adžić (član povjerenstva)
• Committee member: Venija Cerovečki Nekić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Family Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Family Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Kardiovaskularne bolesti predstavljaju najvažniji uzrok smrti i onesposobljenosti u pacijenata sa šećernom bolešću. Šećerna bolest predstavlja samostalni rizični čimbenik za razvoj srčanog zatajivanja. U pacijenata sa šećernom bolešću i srčanim zatajivanjem češće se javljaju lošiji ishodi i veći je broj hospitalizacija. Patogeneza razvoja srčanog zatajivanja u šećernoj bolesti je kompleksna i nije do kraja razjašnjena. Utjecaj srčanog zatajivanja i dijabetesa je uzajaman. Miokardijalna oštećenja javljaju se već u predijabetičkom stadiju bolesti. Promjene zahvaćaju metabolizam u miocitima koji je u takvih pacijenata obilježen relativnom srčanom ishemijom. Funkcionalne promjene obuhvaćaju promijenjenu kontraktilnost miokarda posredovanu promijenjenom regulacijom kalcija u i izvan miocita. Uz to dolazi do razvoja promjena u mikrocirkulaciji i u neurohumoralnoj regulaciji. U liječenju srčanog zatajivanja koriste se ACE- inhibitori i beta blokatori, a kao simptomatski lijekovi i diuretici. Za regulaciju šećerne bolesti metformin je prvi izbor prema smjernicama, ali su u upotrebi mogući i drugi oralni hipoglikemici poput SGLT2 inhibitora. Regulacija glikemije u oboljelih od šećerne bolesti važan je prediktorni čimbenik za razvoj srčanog zatajivanja.

Abstract (english)

Cardiovascular diseases represent the most important cause of death and disability of patients with diabetes mellitus. Diabetes mellitus is an independent risk factor in development of heart failure. Patients with both diabetes and heart failure more often have poor outcome and more often need hospital care. Pathogenesis of heart failure in patients with diabetes is complicated and yet has not been cleared. The impact of heart failure and diabetes is mutual. Myocardial damages are present in prediabetic stage of disease. The metabolism in myocytes in those patients is changed and characterized by relative hearth ischemic. Functional changes include damaged myocardial contractility caused by changed regulation of calcium transport in myocytes and outside of them. There are also changes in microcirculation and neurohumoral regulation. Treatment of heart failure consists of ACE inhibitors, beta blockers and diuretics (for symptoms of congestion). Metformin, which is suggested by guidelines, is most commonly used in treatment of diabetes, but also other medications such as SGLT2 inhibitors are used. Regulation of blood glucose is an important predictive factor in the development of heart failure.

• Keywords: šećerna bolest; srčano zatajivanje; predijabetes; srčana ishemija
• Keywords (english): diabetes mellitus; heart failure; prediabetic stage; heart ischemic
• Language: croatian
• URN:NBN: urn:nbn:hr:105:534264
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-11 12:05:04