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Jin Joo Park 2 Articles
Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes
Jin Joo Park
Diabetes Metab J. 2021;45(5):796-796.   Published online September 30, 2021
DOI: https://doi.org/10.4093/dmj.2021.0239
Corrects: Diabetes Metab J 2021;45(2):146
  • 4,010 View
  • 118 Download
  • 1 Web of Science
  • 6 Crossref
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Citations to this article as recorded by  
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    Bo Yuan, Wei Yang, Na Zhang, Hongyan Shi, Shuangpeng Dong
    Practical Laboratory Medicine.2023; 37: e00338.     CrossRef
  • Defining the Phenotypes for Heart Failure With Preserved Ejection Fraction
    Dane Rucker, Jacob Joseph
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Cardiovascular Risk/Epidemiology
Article image
Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes
Jin Joo Park
Diabetes Metab J. 2021;45(2):146-157.   Published online March 25, 2021
DOI: https://doi.org/10.4093/dmj.2020.0282
Correction in: Diabetes Metab J 2021;45(5):796
  • 17,896 View
  • 1,396 Download
  • 71 Web of Science
  • 75 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.

Citations

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