The Study Of Endothelial Function And Prognosis In Patients With Type 2 Diabetes And Heart Failure With Mid-range Ejection Fraction

Objective:To explore the effect of type 2 diabetes on the vascular endothelial function of patients with heart failure with mid-range ejection fraction(HFmrEF),and to explore the impact of endothelial function damage on the long-term prognosis of HFmrEF.Metohds:Enrolled 87 patients with type 2 diabetes and heart failure with mid-range ejection fraction(T2DM-HFmrEF)who have been hospitalized at the department of cardiology of the First Affiliated Hospital of Xinjiang Medical University from December 2018 to January 2020,and 98 patients with HFmrEF alone were included.There were 70 matched physical examination healthy subjects。Record the baseline data of the research subjects。The levels of serum TNF-ɑ,IL-6,v WF,e NOs and E-selectin were determined by enzyme-linked immunosorbent assay(ELISA).Follow up the primary endpoint events(all-cause death,exacerbation of heart failure and rehospitalization or exacerbation of heart failure)and secondary endpoint events(non-fatal myocardial infarction,stable and unstable angina pectoris,stroke)by telephone or outpatient review,the median follow-up time was 15.4(13.57,17.00)months.Analyze the oxidative stress and vascular endothelial function related indicators of the 3 groups.Results:The levels of TNF-ɑ,IL-6,v WF and E-selectin in the HFmrEF combined with diabetes group were higher than those in the HFmrEF without diabetes group(P<0.05).Multivariate Cox regression analysis showed that BNP(HR=1.001,P=0.036),e NOs(HR=1.04,P<0.001),IL-6(HR=1.002,P<0.001)were related to the primary end point of all patients with HFmrEF.Glycated hemoglobin(HR=1.37,P=0.046),E-selectin(HR=1.01,P=0.003),v WF(HR=1.02,P=0.017),IL-6(HR=1.006,P=0.005)were related to the secondary end point of all patients with HFmrEF.The secondary endpoint events were further analyzed by subgroups.Shows that E-selectin(HR=1.014,P=0.012)and IL-6(HR=1.008,P=0.007)were related to the secondary endpoint events in the HFmrEF combined with diabetes group,but were not related to The secondary end point events of the non-diabetic group(P>0.05).Conclusions:Oxidative stress and vascular endothelial function damage may be involved in the pathogenesis of T2DM-HFmrEF.Serum IL-6 and E-selectin levels are related to the endpoint events in T2DM-HFmrEF patients.