Walker, AMN, Patel, PA, Rajwani, A, Groves, D, Denby, C, Kearney, L, Sapsford, RJ, Witte, KK, Kearney, MT and Cubbon, RM (2016) Diabetes mellitus is associated with adverse structural and functional cardiac remodelling in chronic heart failure with reduced ejection fraction. Diabetes and Vascular Disease Research, 13 (5). pp. 331-340. ISSN 1479-1641

Preview

Text ) Diabetes mellitus is associated with adverse structural and functional cardiac remodelling.pdf - Accepted Version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (158kB) | Preview

Abstract

Background: Diabetes mellitus is associated with an increased risk of death and hospitalisation in patients with chronic heart failure. Better understanding of potential underlying mechanisms may aid the development of diabetes mellitus-specific chronic heart failure therapeutic strategies. Methods: Prospective observational cohort study of 628 patients with chronic heart failure associated with left ventricular systolic dysfunction receiving contemporary evidence-based therapy. Indices of cardiac structure and function, along with symptoms and biochemical parameters, were compared in patients with and without diabetes mellitus at study recruitment and 1 year later. Results: Patients with diabetes mellitus (24.2%) experienced higher rates of all-cause [hazard ratio, 2.3 (95% confidence interval, 1.8-3.0)] and chronic heart failure-specific mortality and hospitalisation despite comparable pharmacological and device-based therapies. At study recruitment, patients with diabetes mellitus were more symptomatic, required greater diuretic doses and more frequently had radiologic evidence of pulmonary oedema, despite higher left ventricular ejection fraction. They also exhibited echocardiographic evidence of increased left ventricular wall thickness and pulmonary arterial pressure. Diabetes mellitus was associated with reduced indices of heart rate variability and increased heart rate turbulence. During follow-up, patients with diabetes mellitus experienced less beneficial left ventricular remodelling and greater deterioration in renal function. Conclusion: Diabetes mellitus is associated with features of adverse structural and functional cardiac remodelling in patients with chronic heart failure.

Item Type:	Article
Additional Information:	Walker AM, Patel PA, Rajwani A, et al. Diabetes mellitus is associated with adverse structural and functional cardiac remodelling in chronic heart failure with reduced ejection fraction. Diabetes and Vascular Disease Research. 2016;13(5):331-340, Copyright © 2016, The Authors. DOI: doi:10.1177/1479164116653342 Reuse is restricted to non-commercial and no derivative uses
Uncontrolled Keywords:	Humans; Ventricular Dysfunction, Left; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Chronic Disease; Echocardiography; Stroke Volume; Electrocardiography, Ambulatory; Prognosis; Hospitalization; Cause of Death; Risk Factors; Prospective Studies; Ventricular Function, Left; Ventricular Remodeling; Time Factors; Aged; England; Female; Male; Heart Failure; Kaplan-Meier Estimate; Diabetic Cardiomyopathies; Diabetes mellitus; aetiology; chronic heart failure; remodelling; Aged; Cause of Death; Chronic Disease; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Cardiomyopathies; Echocardiography; Electrocardiography, Ambulatory; England; Female; Heart Failure; Hospitalization; Humans; Kaplan-Meier Estimate; Male; Prognosis; Prospective Studies; Risk Factors; Stroke Volume; Time Factors; Ventricular Dysfunction, Left; Ventricular Function, Left; Ventricular Remodeling; 1103 Clinical Sciences; 1115 Pharmacology and Pharmaceutical Sciences; 1116 Medical Physiology; Endocrinology & Metabolism
Subjects:	R Medicine > R Medicine (General)
Divisions:	Nursing and Advanced Practice
Publisher:	SAGE Publications
SWORD Depositor:	A Symplectic
Date Deposited:	23 Oct 2024 10:53
Last Modified:	23 Oct 2024 10:53
DOI or ID number:	10.1177/1479164116653342
URI:	https://researchonline.ljmu.ac.uk/id/eprint/24571

View Item