Association of complication of type 2 diabetes mellitus with hemodynamics and exercise capacity in patients with heart failure with preserved ejection fraction: a case–control study in individuals aged 65–80 years
Authors' conclusion
Our results suggested that comorbid T2DM in patients with HFpEF may reduce exercise capacity, HR response, peripheral oxygen extraction, and ventilation efficiency. These results may help identify cardiovascular phenotypes of HFpEF complicated with T2DM and intervention targets for improving exercise intolerance.
Study context
- Population
- Stable outpatients with heart failure with preserved ejection fraction (HFpEF) aged 65–80 years and age-and-sex-matched controls99 HFpEF + 50 controls
- Participants
- 51 / 48 / 50
- Comparison
- HFpEF with T2D vs HFpEF without T2D vs controls
- With T2DMn = 51
- Without T2DMn = 48
- Controlsn = 50reference
- Outcome
- Exercise capacity (peakVO2) and hemodynamics (peak HR, peak stroke volume index, peak a-vO2 diff, VE vs VCO2 slope) by CPET and impedance cardiography
Methodological detailsage-and-sex-matched controls, analysis of covariance adjusted for β-blocker, sarcopenia and hemoglobin
- Age-and-sex-matched controls
- Analysis of covariance adjusted for β-blocker, sarcopenia and hemoglobin
Main finding
As reported in the abstract
Exercise capacity and hemodynamics (medians)
| Group | Value | Peak HR (bpm/min) | Peak a-vO2 (mL/100 mL) | VE vs VCO2 slope |
|---|---|---|---|---|
| Controls | median 23.5 mL/min/kg | 164 | 13.1 | 33.2 |
| Without T2DM | median 15.1 mL/min/kg | 132 | 10.6 | 35.0 |
| With T2DM | median 11.6 mL/min/kg | 120 | 8.9 | 38.2 |
Value
Controlsmedian 23.5 mL/min/kg
Without T2DMmedian 15.1 mL/min/kg
With T2DMmedian 11.6 mL/min/kg
Peak HR (bpm/min)
Controls164
Without T2DM132
With T2DM120
Peak a-vO2 (mL/100 mL)
Controls13.1
Without T2DM10.6
With T2DM8.9
VE vs VCO2 slope
Controls33.2
Without T2DM35.0
With T2DM38.2
- With T2DM vs Without T2DM: P < 0.001 — peakVO2, peak HR, peak a-vO2 and VE vs VCO2 slope significantly worsened with T2DM vs without T2DM and controls
Further findings
| Outcome | P value |
|---|---|
| Prevalence of sarcopenia, chronotropic incompetence and anemiaWith T2DM vs Without T2DM · significantly higher with T2DM vs without T2DM and controls | P < 0.001 |
Original publication
Association of complication of type 2 diabetes mellitus with hemodynamics and exercise capacity in patients with heart failure with preserved ejection fraction: a case–control study in individuals aged 65–80 years. Cardiovasc Diabetol. Published 28 April 2023. doi:10.
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