Changes of plasma aldosterone and angiotensin II levels in patients with ischemic cardiomyopathy combined with Type-2 diabetes mellitus and their clinical significance

Objective: To analyze the changes of plasma aldosterone (ALD) and angiotensin II (Ang II) levels in patients with ischemic cardiomyopathy (ICM) combined with Type-2 diabetes mellitus (T2DM) and their clinical significance.

Methods: Sixty-eight patients with ICM combined with T2DM and fifty-two patients with simple ICM treated in the People’s Hospital of Three Gorges University/the First People’s Hospital of Yichang from February 2018 to February 2021 were selected as observation group and control group, respectively. All the patients had intervention with the same neuroendocrine hormone regime. The plasma ALD and Ang II and left ventricular function indexes (left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD)] were measured and compared between the two groups before and after treatment. The correlations of plasma ALD and Ang-II with left ventricular function before treatment were analyzed using Pearson’s correlation analysis. The diagnostic efficacy of plasma ALD and Ang-II in ICM and T2DM was evaluated by the receiver operating characteristic (ROC) curve.

Results: Before treatment, the plasma ALD and Ang II levels in the observation group were (184.42 ± 56.75) ng/L and (46.68 ± 12.16) ng/L, respectively, which were significantly higher than those in the control group [(165.03 ± 45.67) ng/L and (39.70 ± 10.69) ng/L, p< 0.05]. Compared with before treatment, ALD level increased significantly in the observation group while decreased significantly in the control group after treatment (p< 0.05). After treatment, Ang-II level reduced significantly while LVEF increased significantly in both groups (p< 0.05). After treatment, plasma ALD and LVESD in the observation group were significantly higher than those in the control group (p< 0.05), but plasma Ang II level, LVEF and LVEDD showed no statistically significant differences between the two groups (p> 0.05). Before treatment, plasma ALD and Ang II were negatively correlated with LVEF (p< 0.05). Before treatment, the area under the curve (AUC) of plasma ALD and Ang II levels in diagnosing ICM combined with T2DM were 0.689 and 0.704, respectively.

Conclusion: The plasma levels of ALD and Ang-II in patients with ICM combined with T2DM increase significantly, and their diagnostic value is not high. Compared with patients with simple ICM, the decrease in plasma ALD and Ang- II levels is less obvious after the same intervention, but it is still conducive to the improvement of cardiac function.