Endocrine Abstracts

Introduction

Heart Failure with Preserved Ejection Fraction (HFpEF) denotes a growing challenge due to the population aging and the rising prevalence of cardiovascular risk factors.

Aim

We aimed to evaluate the influence of the diagnosis of diabetes mellitus (DM) on the signs and symptoms, comorbidities and echocardiographic and vascular evaluation of patients with HFpEF in a stable phase.

Methods

Cross-sectional study including 94 patients with HFpEF in stable phase, followed in our center. Signs, symptoms and comorbidities were obtained by anamnesis, physical examination and patient medical records. The cardiac function was evaluated by echocardiography performed by expert cardiologists. Endothelial function (Reactive Hyperemia Index) was evaluated with the EndoPATTM2000 device, and carotid-femoral pulse wave velocity. The associations between DM and previously defined outcomes were assessed through linear and logistic regression models, adjusted for sex, age, systolic blood pressure (SBP) and body mass index (BMI).

Results

The included population (n = 94) has an average age of 73.8 ± 8.8 years and 53.8% are males. Average BMI is 29.4 ± 5.3 kg/m² and 52.7% of the patients have DM. Concerning signs and symptoms, no differences were recorded regarding oedema, NYHA class, orthopnea or nocturnal paroxysmal dyspnea. About comorbidities, patients with DM have higher SBP (OR 14.2 [5.0 to 23.4] mmHg; P < 0.01), and higher prevalence of both peripheral arterial (OR 15.5 [2.6 to 92.7]; P < 0.01) and cardiovascular atherosclerotic (OR 6.4 [1.5 to 26.8]; P = 0.011) diseases. The echocardiographic evaluation showed that patients with DM have an inferior isovolumetric relaxation time (ms) comparing to patients without DM (ß = –11.4 [-22.4 to -0.36]; P = 0.019). Patients with DM have a higher pulse wave velocity (m/s), comparing to patients without DM (ß=2.13 [0.92 to 3.33]; P < 0.01).

Conclusion

In patients with HFpEF, the presence of DM associates not only to higher prevalence of comorbidities but also to deleterious cardiac structural and vascular changes.