Myocardial considerations in type 2 diabetes: 2018

作者：Robert Ćhilton, Charles Lin, Kelly M. Gallegos, Son V. Pham · 发表于：Journal of Diabetes · 年份：2018 · DOI：10.1111/1753-0407.12788 · 被引用次数：1 · 研究领域：Diabetes Treatment and Management、Cardiovascular Function and Risk Factors、Diet and metabolism studies

Heart failure (HF) continues to be one of the biggest public health problems in the 21st century, affecting 5.7 million adults in the US and accounting for one in nine deaths. Half of those developing HF die within 5 years of diagnosis. The cost associated with HF (i.e. for healthcare services, medications, and missed days of work) is estimated to be US$30 billion dollars per year.1 The leading causes of HF continue to be coronary heart disease (the most common), hypertension, and diabetes.2 In recent years, increasing numbers of patients with diabetes developing shortness of breath have been found to have left ventricular (LV) diastolic dysfunction. This is found in approximately 28% of asymptomatic and 81% of symptomatic patients with HF and is referred to as HF with preserved ejection fraction (HFpEF). Currently, there is no good treatment for HFpEF, with a number of failed trials.3 Moreover, recent landmark HF trials had only a low prevalence of diabetes patients (see Fig. 1). Bursi et al.5 prospectively evaluated 556 patients from Olmsted County (MN, USA) using echocardiograms, finding that 44% of patients in that community had isolated LV diastolic dysfunction. At 6 months, mortality was 16% for both preserved and reduced ejection fraction (EF; age- and sex-adjusted hazard ratio 0.85; 95% confidence interval [CI] 0.61–1.19; P = 0.33 for preserved vs reduced EF).5 In summary, HF is found and well recognized in diabetes patients. It is also frequently reported as diastoli...