Prevalence, clinical characteristics, and echocardiographic phenotypes of heart failure in patients with type 2 diabetes mellitus

Aim

To estimate the prevalence and echocardiographic phenotypes of heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) admitted to the hospital.

Material and methods

1008 patients with T2DM were enrolled in a single-center prospective cohort study. Echocardiographic phenotypes of HF, that is, with preserved, mid-range, and reduced ejection fraction, were defined according to the 2016 European Guidelines for the Diagnosis and Treatment of HF.

Results

The diagnosis of HF was established in 686 (68.1%) patients with T2DM. Echocardiography showed preserved, mid-range and reduced ejection fraction in 47.2%, 26.5% and 26.2% of HF patients, respectively. Patients with preserved ejection fraction were older than patients with the other phenotypes of HF and patients without HF. Most patients (67.6%) with HF with preserved ejection fraction were females, whereas most patients (76.7%) with reducted ejection fraction were males. The occurrence of coronary artery disease was similar in patients without HF and patients with HF with preserved ejection fraction. However, more patients in the latter group had a history of myocardial infarction. In patients with reduced ejection fraction, NT-proBNP level was significantly higher than in patients with preserved and midrange ejection fraction. Anemia and estimated glomerular filtration rate lower than 60 ml/min/1.73 m 2 occurred more frequently in HF patients than in patients without HF, alhough their prevalence did non depend on ejection fraction.

Conclusion

HF (with preserved ejection fraction in half of cases) was detected in 68.1% of hospitalized patients with T2DM and was frequently associated with GFR less than 60 ml/min/1.73 m 2 and anemia, regardless of the HF phenotype.

Key words

Type 2 diabetes mellitus, heart failure, HF with reduced ejection fraction, HF with mid-range ejection fraction, HF with preserved ejection fraction, registry.