Long-term LVEF trajectories in patients with type 2 diabetes and heart failure
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 ai...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Publication date: | 2020 |
| Country: | España |
| Institution: | Universitat Autònoma de Barcelona |
| Repository: | Dipòsit Digital de Documents de la UAB |
| Language: | English |
| OAI Identifier: | oai:ddd.uab.cat:227715 |
| Online Access: | https://ddd.uab.cat/record/227715 https://dx.doi.org/urn:doi:10.1186/s12933-020-01011-w |
| Access Level: | Open access |
| Keyword: | Heart failure Diabetes mellitus Ejection fraction Etiology Long-term Follow-up |
| _version_ | 1878733168098410496 |
|---|---|
| author | Julián, María Teresa|||0000-0003-2524-1823 |
| author2 | Alonso Pedrol, Núria|||0000-0001-9687-8050 Lupón, Josep|||0000-0002-5601-9611 Gavidia-Bovadilla, Giovana Ferrer, Elena|||0000-0001-5853-8207 de Antonio Ferrer, Marta|||0000-0002-4319-797X López Ayerbe, Jorge|||0009-0008-8495-0877 Domingo, Mar|||0000-0002-2935-1272 Santiago Vacas, Evelyn|||0000-0001-7511-406X Zamora, Elisabet|||0000-0001-5317-7481 Codina, Pau|||0000-0002-2469-5711 Moliner, P.|||0000-0002-5511-8597 Núñez, Julio|||0000-0003-1672-7119 Santesmases Ejarque, Javier|||0000-0002-1226-1617 Puig Domingo, Manuel|||0000-0002-6744-7195 Bayés-Genís, Antoni|||0000-0002-3044-197X |
| author2_role | author author author author author author author author author author author author author author author |
| author_browse | Alonso Pedrol, Núria|||0000-0001-9687-8050 Bayés-Genís, Antoni|||0000-0002-3044-197X Codina, Pau|||0000-0002-2469-5711 Domingo, Mar|||0000-0002-2935-1272 Ferrer, Elena|||0000-0001-5853-8207 Gavidia-Bovadilla, Giovana Julián, María Teresa|||0000-0003-2524-1823 Lupón, Josep|||0000-0002-5601-9611 López Ayerbe, Jorge|||0009-0008-8495-0877 Moliner, P.|||0000-0002-5511-8597 Núñez, Julio|||0000-0003-1672-7119 Puig Domingo, Manuel|||0000-0002-6744-7195 Santesmases Ejarque, Javier|||0000-0002-1226-1617 Santiago Vacas, Evelyn|||0000-0001-7511-406X Zamora, Elisabet|||0000-0001-5317-7481 de Antonio Ferrer, Marta|||0000-0002-4319-797X |
| author_facet | Julián, María Teresa|||0000-0003-2524-1823 Alonso Pedrol, Núria|||0000-0001-9687-8050 Lupón, Josep|||0000-0002-5601-9611 Gavidia-Bovadilla, Giovana Ferrer, Elena|||0000-0001-5853-8207 de Antonio Ferrer, Marta|||0000-0002-4319-797X López Ayerbe, Jorge|||0009-0008-8495-0877 Domingo, Mar|||0000-0002-2935-1272 Santiago Vacas, Evelyn|||0000-0001-7511-406X Zamora, Elisabet|||0000-0001-5317-7481 Codina, Pau|||0000-0002-2469-5711 Moliner, P.|||0000-0002-5511-8597 Núñez, Julio|||0000-0003-1672-7119 Santesmases Ejarque, Javier|||0000-0002-1226-1617 Puig Domingo, Manuel|||0000-0002-6744-7195 Bayés-Genís, Antoni|||0000-0002-3044-197X |
| author_role | author |
| collection | Dipòsit Digital de Documents de la UAB |
| description | 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_514b04719a3fa10ff3e92fd8e4ed8b1f |
| institution | Universitat Autònoma de Barcelona |
| instname_str | Universitat Autònoma de Barcelona |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:ddd.uab.cat:227715 |
| publishDate | 2020 |
| publishDateSort | 2020 |
| reponame_str | Dipòsit Digital de Documents de la UAB |
| spelling | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure diabetic cardiomyopathy may underlie functional decline Julián, María Teresa|||0000-0003-2524-1823 Alonso Pedrol, Núria|||0000-0001-9687-8050 Lupón, Josep|||0000-0002-5601-9611 Gavidia-Bovadilla, Giovana Ferrer, Elena|||0000-0001-5853-8207 de Antonio Ferrer, Marta|||0000-0002-4319-797X López Ayerbe, Jorge|||0009-0008-8495-0877 Domingo, Mar|||0000-0002-2935-1272 Santiago Vacas, Evelyn|||0000-0001-7511-406X Zamora, Elisabet|||0000-0001-5317-7481 Codina, Pau|||0000-0002-2469-5711 Moliner, P.|||0000-0002-5511-8597 Núñez, Julio|||0000-0003-1672-7119 Santesmases Ejarque, Javier|||0000-0002-1226-1617 Puig Domingo, Manuel|||0000-0002-6744-7195 Bayés-Genís, Antoni|||0000-0002-3044-197X Heart failure Diabetes mellitus Ejection fraction Etiology Long-term Follow-up 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. https://ddd.uab.cat/record/227715 https://dx.doi.org/urn:doi:10.1186/s12933-020-01011-w |
| spellingShingle | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure Julián, María Teresa|||0000-0003-2524-1823 Heart failure Diabetes mellitus Ejection fraction Etiology Long-term Follow-up |
| title | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure |
| title_full | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure |
| title_fullStr | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure |
| title_full_unstemmed | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure |
| title_short | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure |
| title_sort | Long-term LVEF trajectories in patients with type 2 diabetes and heart failure |
| topic | Heart failure Diabetes mellitus Ejection fraction Etiology Long-term Follow-up |
| topic_facet | Heart failure Diabetes mellitus Ejection fraction Etiology Long-term Follow-up |
| url | https://ddd.uab.cat/record/227715 https://dx.doi.org/urn:doi:10.1186/s12933-020-01011-w |