Heart failure & cardiomyopathies
Type 2 diabetes in heart failure with preserved and mildly reduced ejection fraction: insights from the REDUCE-LAP-HF II trial
Authors' conclusion
HFpEF/HFmrEF patients with T2DM experience adverse myocardial remodelling, impaired biventricular function, adverse central haemodynamics, and worse clinical outcomes independent of obesity. These findings indicate that T2DM confers additional metabolic burden to the myocardium, beyond that attributable to obesity alone.
Study context
- Population
- Patients with HFpEF/HFmrEF undergoing invasive haemodynamic assessmentsham-control arm of the REDUCE LAP-HF II trial
- Participants
- 312 patients
- Exposure
- T2DM vs no T2DM, adjusted for body mass index (BMI) and clinical covariates
- Outcome
- Prevalence of T2DM
Methodological detailssham-control arm of the REDUCE LAP-HF II trial, invasive haemodynamic assessment, multivariable models adjusted for BMI and clinical covariates
- Sham-control arm of the REDUCE LAP-HF II trial
- Invasive haemodynamic assessment
- Multivariable models adjusted for BMI and clinical covariates
Main finding
As reported in the abstract
T2DM present
37%
Observational data: associations, not effects.
Further findings
Obesity · more prevalent in those with T2DM
P = 0.032
Heart failure (HF) events or cardiovascular (CV) death · median of 4.0-year (2.5-5.0) follow-up
| Adjusted hazard ratio (95% CI) | ||
|---|---|---|
| T2DMIncreased risk with T2DM; driven by HF events | 1.96 (1.28–3.00) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- Obesity — Obesity present overall
- 62%
Cardiac structure, function and haemodynamics
- T2DM independently associated with greater left ventricular mass, lower EF, impaired left ventricular global longitudinal strain, reduced right ventricular free-wall strain, and higher resting filling pressures
- After adjustment for BMI
HF events or CV death · median of 4.0-year (2.5-5.0) follow-up
- BMI was not independently prognostic
Original publication
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