The study is necessitated by the need to investigate the effect of catestatin on the structural and functional myocardial state in patients with chronic heart failure under conditions of cardiometabolic polymorbidity (type 2 diabetes mellitus and obesity). The aim was to evaluate the role of catestatin in the formation of structural and functional changes in the myocardium in patients with chronic heart failure in coronary artery disease with concomitant type 2 diabetes mellitus and obesity. The study involved 225 patients who were divided into four groups depending on the presence of metabolic disorders. A transthoracic echocardiographic examination was performed to assess the morphofunctional state of the myocardium. The level of catestatin in blood serum was determined by immunoenzymatic method. Spearman’s correlation coefficient was used to assess the degree of correlation. The results showed that the most unfavourable indicators of left ventricular remodelling, including the maximum increase in end-systolic volume (101.57 mL) and end-diastolic volume (192.16 mL), as well as the lowest ejection fraction (42.67%), were recorded in patients with a combination of chronic heart failure, coronary artery disease, type 2 diabetes mellitus and obesity. This group had the lowest level of catestatin (1.53 ng/mL), which was 78.0% lower than in patients without metabolic disorders. Correlation analysis confirmed a strong direct relationship between catestatin levels and left ventricular ejection fraction (r=0.68), as well as strong inverse correlations with end-diastolic volume (r=−0.69) and end-systolic volume (r=−0.67). A decrease in catestatin concentration is closely associated with an increase in left ventricular volume, its pathological remodelling, and a decrease in pumping function. The presence of polymorbid pathology leads to the most pronounced dilated type of left ventricular remodelling, and low catestatin levels are not only a marker but also a probable participant in the pathogenesis of adverse structural and functional changes in the myocardium
A Wed, study studied this question.