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.

Prevention, diagnosis, and treatment of obesity. 2016 position statement of the Spanish Society for the Study of Obesity.

Prevención, diagnóstico y tratamiento de la obesidad. Posicionamiento de la Sociedad Española para el Estudio de la Obesidad de 2016

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.