The two different profiles in heart failure with preserved ejection fraction and type 2 diabetes mellitus: ischemic and diabetic.
| Autor: | Arévalo Lorido JC; Internal Medicine Department, University Hospital of Badajoz, Badajoz, Spain., Carretero Gómez J; Internal Medicine Department, University Hospital of Badajoz, Badajoz, Spain., Conde Martel A; Internal Medicine Department, Dr. Negrín University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain., Aramburu Bodas O; Internal Medicine Department, Virgen Macarena University Hospital, Sevilla, Spain., Trullás JC; Internal Medicine Department, Olot and Garrotxa Regional Hospital, Olot, Girona, Spain.; Tissue Repair and Regeneration Laboratory (TR2Lab), School of Medicine, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain., Carrasco Sánchez FJ; Internal Medicine Department, Juan Ramón Jiménez University Hospital, Huelva, Spain., Manzano Espinosa L; Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain., Cerqueiro González JM; Internal Medicine Department, Lucus Augusti University Hospital, Lugo, Spain., Moreno García C; Internal Medicine Department, Manises Hospital, Manises, Valencia, Spain., Casado Cerrada J; Internal Medicine Department, University Hospital of Getafe, Getafe, Madrid, Spain., Montero Pérez-Barquero M; Internal Medicine Department, IMIBIC Reina Sofía University Hospital, Córdoba, Spain. |
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| Jazyk: | angličtina |
| Zdroj: | Current medical research and opinion [Curr Med Res Opin] 2024 Mar; Vol. 40 (3), pp. 359-366. Date of Electronic Publication: 2024 Jan 19. |
| DOI: | 10.1080/03007995.2024.2303089 |
| Abstrakt: | Objective: Two profiles of patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM) can be discerned: those with ischemic and those with diabetic cardiomyopathy (DMC). We aim to analyze clinical differences and prognosis between patients of these two profiles. Material and Methods: This cohort study analyzes data from the Spanish Heart Failure Registry, a multicenter, prospective registry that enrolled patients admitted for decompensated heart failure and followed them for one year. Three groups were created according to the presence of T2DM and heart disease depending on the etiology (ischemic when coronary artery disease was present, or DMC when no coronary, valvular, or congenital heart disease; no hypertension; nor infiltrative cardiovascular disease observed on an endomyocardial biopsy). The groups and outcomes were compared. Results: A total of 466 patients were analyzed. Group 1 ( n = 210) included patients with ischemic etiology and T2DM. Group 2 ( n = 112) included patients with DMC etiology and T2DM. Group 3 ( n = 144), a control group, included patients with ischemic etiology and without T2DM. Group 1 had more hypertension and dyslipidemia; group 2 had more atrial fibrillation (AF) and higher body mass index; group 3 had more chronic kidney disease and were older. In the regression analysis, group 3 had a better prognosis than group 1 (reference group) for cardiovascular mortality and HF readmissions (HR 0.44;95%CI 0.2-1; p = .049). Conclusions: Patients with T2DM and HFpEF, who had the poorest prognosis, were of two different profiles: either ischemic or DMC etiology. The first had a higher burden of cardiovascular disease and inflammation whereas the second had a higher prevalence of obesity and AF. The first had a slightly poorer prognosis than the second, though this finding was not significant. |
| Databáze: | MEDLINE |
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