Long-term LVEF trajectories in patients with type 2 diabetes and heart failure : diabetic cardiomyopathy may underlie functional decline
Julián, María Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Alonso Pedrol, Núria (Universitat Autònoma de Barcelona. Departament de Medicina)
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gavidia-Bovadilla, Giovana (Hospital Clínic Universitari (València))
Ferrer, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
de Antonio Ferrer, Marta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
López-Ayerbe, Jorge (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domingo, Mar (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Santiago Vacas, Evelyn (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Zamora, Elisabet (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Codina, Pau (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Moliner, Pedro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Núñez, Julio (Universitat de València. Departament de Medicina)
Santesmases, Javier (Universitat Autònoma de Barcelona. Departament de Medicina)
Puig Domingo, Manuel (Universitat Autònoma de Barcelona. Departament de Medicina)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Fecha:	2020
Resumen:	Left ventricular ejection fraction (LVEF) trajectories and functional recovery with current heart failure (HF) management is increasingly recognized. Type 2 diabetes mellitus (T2D) leads to a worse prognosis in HF patients. However, it is unknown whether T2D interferes with LVEF trajectories. The aim of this study was to prospectively assess very long-term (up to 15 years) LVEF trajectories in patients with and without T2D and underlying HF. Ambulatory patients admitted to a multidisciplinary HF clinic were prospectively evaluated by scheduled two-dimensional echocardiography at baseline, 1 year, and then every 2 years afterwards, up to 15 years. Statistical analyses of LVEF change with time were performed using the linear mixed effects (LME) models, and locally weighted error sum of squares (Loess) curves were plotted. Of the 1921 patients, 461 diabetic and 699 non-diabetic patients with LVEF < 50% were included in the study. The mean number of echocardiography measurements performed in diabetic patients was 3. 3 ± 1. 6. Early LVEF recovery was similar in diabetic and non-diabetic patients, but Loess curves showed a more pronounced inverted U shape in diabetics with a more pronounced decline after 9 years. LME analysis showed a statistical interaction between T2D and LVEF trajectory over time (p = 0. 009), which was statistically significant in patients with ischemic etiologies (p < 0. 001). Other variables that showed an interaction between LVEF trajectories and T2D were male sex (p = 0. 04) and HF duration (p = 0. 008). LVEF trajectories in T2D patients with depressed systolic function showed a pronounced inverted U shape with a marked decline after 9 years. Diabetic cardiomyopathy may underlie the functional decline observed.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Heart failure ; Diabetes mellitus ; Ejection fraction ; Etiology ; Long-term ; Follow-up
Publicado en:	Cardiovascular diabetology, Vol. 19 (march 2020) , ISSN 1475-2840

DOI: 10.1186/s12933-020-01011-w
PMID: 32293458

11 p, 2.0 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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