Metformin and left ventricular hypertrophy in patients with comorbidity

Essential hypertension (EH) stays the important public challenge, because of leading positions in morbidity and mortality in not only Ukraine, but also worldwide. Recent studies have suggested that metformin could inhibit cardiomyocyte apoptosis and improve cardiac function.Aim of the study was to investigate metformin’s influence on left ventricular structure and function in patients with essential hypertension with concomitant type 2 diabetes (T2D).Materials and methods: 120 patients with essential hypertension (EH) were recruited in the study and were divided into three groups according to comorbid state: 60  - EH and T2D; 30 – EH with prediabetes; 30 – EH without dysglicemia. Carbohydrate parameters, left ventricle structure and function were analyzed before and after 12 weeks of metformin treatment.Results. Metformin treatment results in fasting glycaemia and insulin resistance diminishing on 21,79 % and 26,84 %.  Echocardiography in 12 weeks metformin treatment showed significant decreasing of left ventricle myocardium mass for 6,1 %, left ventricle posterior wall thickness - 2,3 %. More pronounced changes in patients with EH and T2D are connected with glucotoxicity, lipotoxicity, insulin resistance diminishing and also with pleiotropic metformin’s effects.Conclusion. Metformin has positive influence to the structure and function of left ventricle with increasing of EDV and LV hypertrophy regress. These findings may provide a potential effectiveness for patients with T2D at risk of developing pathological cardiac hypertrophy.Key words: essential hypertension, type 2 diabetes, left ventricle hypertrophy, metformin.