Sex differences in clinical profile, left ventricular remodeling and cardiovascular outcomes among diabetic patients with heart failure and reduced ejection fraction: a cardiac-MRI-based study
Authors' conclusion
Among patients with HFrEF concomitant with DM, women displayed different LV remodeling and risk factors and had better survival than men did. Sex-based phenotypic heterogeneity in patients with HFrEF in the context of DM should be addressed in clinical practice.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) concomitant with diabetes mellitus (DM) who underwent cardiac MRI
- Participants
- 273 patients
- Exposure
- Women vs men
- Outcome
- Overall survival
- Follow-up
- Median 34.6 months
Methodological detailscardiac MRI-based
- Cardiac MRI-based
Main finding
As reported in the abstract
- Women exhibited better overall survival than men
- Women vs Men: log-rank P = 0.042
Observational data: associations, not effects.
Further findings
Clinical profile
- Women were older, leaner, more prone to anemia and hypoproteinemia, less likely to have ischemic etiology
Left ventricular (LV) remodeling on cardiac MRI
- Similar LVEFs; women had more LV concentric remodeling, less impaired global systolic peak longitudinal and circumferential strain, and lower likelihood of late gadolinium enhancement than men
Independent determinants of outcomes in women (multivariable Cox)
- Hypertension: HR 2.05, 95% CI 1.05 to 4.85, P = 0.041
- Hypoproteinemia: HR 2.27, 95% CI 1.06 to 4.37, P = 0.039
Independent determinants of outcomes in men (multivariable Cox)
- Ischemic etiology: HR 1.96, 95% CI 1.11 to 3.48, P = 0.021
- AF: HR 1.86, 95% CI 1.02 to 3.41, P = 0.044
Original publication
Sex differences in clinical profile, left ventricular remodeling and cardiovascular outcomes among diabetic patients with heart failure and reduced ejection fraction: a cardiac-MRI-based study. Cardiovasc Diabetol. Published 22 July 2024. doi:10.
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