0000000001302553
AUTHOR
Jorge López-ayerbe
Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Abstract Background Left ventricular ejection fraction (LVEF) trajectories and functional recovery with current heart failure (HF) management is increasingly recognized. Type 2 diabetes mellitus (T2D) leads to a worse prognosis in HF patients. However, it is unknown whether T2D interferes with LVEF trajectories. The aim of this study was to prospectively assess very long-term (up to 15 years) LVEF trajectories in patients with and without T2D and underlying HF. Methods Ambulatory patients admitted to a multidisciplinary HF clinic were prospectively evaluated by scheduled two-dimensional echocardiography at baseline, 1 year, and then every 2 years afterwards, up to 15 years. Statistical anal…
Additional file 2 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 2: Table S1. Demographic, clinical, and therapeutic characteristics at baseline and treatments during follow-up according to etiology of heart failure and presence of diabetes mellitus. Table S2. Paired wise means data analysis in diabetic patients. Table S3. Causes of death of the studied cohort during the 15-year follow-up, according the presence or absence of diabetes mellitus. Table S4. Multivariable Cox regression analysis for all-cause death and the composite end-point all-cause death or heart failure hospitalization.
Pulmonary vascular resistance versus pulmonary artery pressure for predicting right ventricular remodeling and functional tricuspid regurgitation.
BACKGROUND Pulmonary hypertension (PH) is a common cause of right ventricular (RV) remodeling and functional tricuspid regurgitation (FTR), but incremental pulmonary artery systolic pressure (PASP) does not always correlate with anatomic and functional RV changes. This study aimed to evaluate a noninvasive measure of pulmonary vascular resistance (PVR) for predicting RV dilatation, RV dysfunction, and severity of FTR. METHODS We prospectively analyzed consecutive stable patients with PASP ≥ 35 mm Hg or any degree of RV dilatation or dysfunction secondary to PH. Noninvasive PVR was calculated based on FTR peak velocity and flow in RV outflow tract. RESULTS We included 251 patients, aged 72.1…
Heart failure with preserved ejection fraction infrequently evolves toward a reduced phenotype in long-term survivors: a long-term prospective longitudinal study
Background: Long-term trajectories of left ventricular ejection fraction (LVEF) in heart failure (HF) patients with preserved EF (HFpEF) remain unclear. Our objective was to assess long-term longitudinal trajectories in consecutive HFpEF patients and the prognostic impact of LVEF dynamic changes over time. Methods and Results: Consecutive ambulatory HFpEF patients admitted to a multidisciplinary HF Unit were prospectively evaluated by 2-dimensional echocardiography at baseline and at 1, 3, 5, 7, 9, and 11 years of follow-up. Exclusion criteria were patients having a previous known LVEF <50%, patients undergoing only 1 echocardiogram study, and those with a diagnosis of dilated, noncompa…
Additional file 8 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 8: Figure S4. Survival and event-free survival curves related to the presence of diabetes mellitus and to etiology (ischemic vs. non-ischemic). Panel B: Event-free survival curves (composite end-point of all-cause death or HF hospitalizations). Diabetic patients from ischemic etiology (dark purple) showed the worse prognosis, while non-diabetic from non-ischemic etiology (blue) showed the best. Remarkably diabetic patients from non-ischemic etiology (soft orange) showed slightly worse prognosis than non-diabetic patients from ischemic etiology (green).
Additional file 1 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 1: Figure S1. Distribution of the number of echocardiograms performed per patient. Number of echocardiograms per patient ranged from 2 (minimum inclusion criteria) to 9 (patients with all the per protocol pre-specified echocardiograms).
Additional file 6 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 6: Figure S3. Loess spline curves of long-term LVEF trajectories based on sex. Panel B: Women. P value for trajectory changes on LVEF <0.001 for both groups. P for comparison between groups (interaction between trajectory changes and diabetes) = 0.14. Shaded regions displayed around curves represent the confidence interval at level = 0.95.
Additional file 5 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 5: Figure S3. Loess spline curves of long-term LVEF trajectories based on sex. Panel A: Men. Diabetic (orange) vs. non-diabetic (blue) patients. P value for trajectory changes on LVEF
Additional file 3 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 3: Figure S2. Loess spline curves of long-term LVEF trajectories based on heart failure duration. Panel A: Patients with HF duration ≤ 12 months; Diabetic (orange) vs. non-diabetic (blue) patients. P value for trajectory changes on LVEF
Additional file 4 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 4: Figure S2. Loess spline curves of long-term LVEF trajectories based on heart failure duration. Panel B: Patients with HF duration > 12 months. P value for trajectory changes on LVEF
Additional file 7 of Long-term LVEF trajectories in patients with type 2 diabetes and heart failure: diabetic cardiomyopathy may underlie functional decline
Additional file 7: Figure S4. Survival and event-free survival curves related to the presence of diabetes mellitus and to etiology (ischemic vs. non-ischemic). Panel A: All-cause death survival curves.