Endothelium protecting properties of taurin in chronic heart failure with type 2 diabetes

High prevalence of chronic heart failure (CHF) and type 2 diabetes (DM2), poor prognosis and low life quality determine the aim for optimum treatment strategy invention. Cornerstone of the treatment in this category of patients is correction of endothelial dysfunction and metabolism disorders that underlie development and progression of CHF and DM2: lipid- and glucose toxicity, insulin resistance (IR).

Aim. To study the effects of taurin treatment as part of combination therapy for CHF with DM2, taking its influence on endothelial dysfunction.

Material and methods. Totally, 60 patients included, after myocardial infarction (MI) lasting 6-12 months, with CHF I-III functional class and comorbid DM2. They were selected to 2 groups: 1st (controls) — patients receiving CHF treatment in postinfarction period and oral glucose lowering drugs, and 2nd (experimental) — patients also taking taurin 500 mg b.i.d. together with CHF and DM2 treatment. Assessment included 6-minute walking test, measurement of brain natriuretic peptide (NT-proBNP) in blood, echocardiography, vascular components of endothelium functioning, plasmatic factors of endothelial function (NO metabolites concentration and endotheline-1 in serum), glucose level, insulin with IR-index, glycosilated hemoglobine, total cholesterol, low density and high density lipoproteides, triglycerides.

Results. It is found, that taurin shows endothelium protecting properties when used as part of combination therapy for CHF and DM2. These properties were noted on microcirculatory (significant in spastic pattern of disorder) level and in elastic arteries. While taking taurin, there was statistically significant increase of NO level in blood and decrease of endotheline-1.

Conclusion. Positive endothelium protecting properties of taurin as part of combination therapy of CHF with DM2 were followed by significant decrease of CHF severity by NT-proBNP levels dynamics, and significant hypolipidemic effect, decrease of IR. 

1. Carolin SP, Lam MS, Brutsaert MD. Endothelial Dysfunction. A Pathophysiologic Factor in Heart Failure With Preserved Ejection Fraction. JACC 2012; 60(18):1787-9.

2. Heitzer T, Baldus S, von Kodolitsch Y, et al. Systemic endothelial dysfunction as an early predictor of adverse outcome in heart failure. Arterioscler Thromb Vasc Biol 2005; 25: 1174-9.

3. de Berrazueta JR, Guerra-Ruiz A, Garcia-Unzueta MT, et al. Endothelial dysfunction, measured by reactive hyperaemia using strain-gauge plethysmography, is an independent predictor of adverse outcome in heart failure. Eur J Heart Fail 2010; 12: 477-83.

4. Shechter M, Matetzky S, Arad M, et al. Vascular endothelial function predicts mortality risk in patients with advanced ischaemic chronic heart failure. Eur J Heart Fail 2009; 11: 588-93.

5. Meyer B, Mortl D, Strecker K, et al. Flow-mediated vasodilation predicts outcome in patients with chronic heart failure: comparison with B-type natriuretic peptide. JACC 2005; 46: 1011-8.

6. Sena CM, Pereira AM, Seiça R. Endothelial dysfunction — A major mediator of diabetic vascular disease. Biochimica et Biophysica Acta (BBA). Molecular Basis of Disease 2013; 1832 (12): 2216-31.

7. Ripps H, Shen W. Review: Taurine: A “very essential” amino acid. Molecular Vision 2012; 18: 2673-86.

8. Takashi I, Schaffer S, Azuma J. The potential usefulness of taurine on diabetes mellitus and its complications. Amino Acids 2012; 42 (5): 1529-39.

9. Abebe W, Mozaffari MS. Role of taurine in the vasculature: an overview of experimental and human studies. Am J Cardiovasc Dis 2011; 1(3): 293-311.

10. Moloney MA, Casey RG, Donnell DH, et al. Two weeks taurine supplementation reverses endothelial dysfunction in young male type 1 diabetics. Diabetes & Vascular Disease Research 2010; 7(4): 300-10.

11. Guo-guang Wang, Wei Li, Xiao-hua Lu, et al. Taurine attenuates oxidative stress and alleviates cardiac failure in type I diabetic rats. Croat Med J 2013; 54: 171-9.

12. Ulrich-Merzenich G, Zeitler H, Vetter H, Bhonde RR. Protective effects of taurine on endothelial cells impaired by high glucose and oxidized low-density lipoproteins. Eur J Nutr 2007; 46: 431-8.

13. Krupatkin AI, Sidorov VV. Laser Doppler flowmetry blood microcirculation. Moscow, 2005. 256 p. Russian (Крупаткин А.И., Сидоров В.В. Лазерная допплеровская флоуметрия микроциркуляции крови. Москва, 2005. 256 с).

14. Ilyukhin OV, Ilyukhina MV, Kalganova EL, et al. The pulse wave velocity in the assessment of endothelial dysfunction in patients with chronic heart failure of ischemic etiology. J Нeart Failure 2005; 1: 16-8. Russian (Илюхин О.В., Илюхина М.В., Калганова Е.Л. и др. Скорость распространения пульсовой волны в оценке эндотелиальной дисфункции у больных с хронической сердечной недостаточностью ишемической этиологии. Ж Сердечная недостаточность 2005; 1: 16-8).

15. Statsenko ME, Vinnikova AA, Ronskaya AM, Shilina NN. Taurine in the treatment of chronic heart failure and type 2 diabetes: the impact on microcirculation and elastic properties of the great vessels. J Heart Failure 2013; 14; 6(80):347-53. Russian (Стаценко М.Е., Винникова А.А., Ронская А.М., Шилина Н.Н. Таурин в терапии хронической сердечной недостаточности и сахарного диабета 2 типа: влияние на микроциркуляцию и эластические свойства магистральных сосудов. Ж Сердечная недостаточность 2013; 14; 6 (80): 347-53).

16. Standards of specialized diabetes care. Clinical Guidelines. Ed. Dedov II, Shestakova MV. 7th Edition. M. 2015, p. 112. Russian (Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Клинические рекомендации. Под ред. И.И. Дедова, М.В. Шестаковой. 7-й выпуск. Москва, 2015, с. 112).