الفهرس 
TYPE II DIABETESOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Patients with diabetes mellitus have a higher prevalence of heart failure than those without it. Approximately 40% of HF patients have DM, having poorer outcomes than those without DM. Myocardial ischemia caused by endothelial dysfunction, obesity and several mechanisms contribute to DM-induced HF. Also, patients with HF show an increased risk for the onset of DM due to several mechanisms including insulin resistance.
Aim of the Work: To investigate frequency of heart failure with preserved ejection fraction in a sample of T2DM egyptian patients attending outpatient clinics.
Patients and Methods: The present study is cross sectional study was conducted on 90 Egyptian subjects with type 2 diabetes,who were participated from Internal Medicine and Endocrine outpatient clinics, Ain Shams University Hospitals for 6 months duration by simple random sampling.
Results: In T2DM patients, 23.3% have heart failure with preserved ejection fraction (HFpEF), and 40% exhibit left ventricular (LV) diastolic dysfunction. Compared to those without HFpEF, patients with HFpEF have significantly higher mean age, HbA1c, NT-proBNP, TAG, total cholesterol, and LDL (all p<0.01). Echocardiographic comparisons reveal higher mean A, LAVI, and TR, and lower mean E/A, septal e’, and lateral e’ in HFpEF patients (all p<0.001). Significant correlations are found between echocardiographic parameters (E, A, E/A, septal e’, lateral e’, LAVI) and age (p<0.05). HbA1c significantly correlates with A, E/A, septal e’, lateral e’, E/e’, LAVI, and TR (p<0.01). TAG shows significant correlations with LVEDD, LVESD, lateral e’, E/e’ lateral, LAVI, and TR (p<0.05). LDL correlates significantly with LVEDD, LVESD, LVEF, and TR (p<0.05). HDL correlates with TR (p<0.001), and urea correlates with A (p=0.037). NT-proBNP significantly correlates with multiple echocardiographic parameters including LVEDD, LVESD, E, A, E/A, septal e’, lateral e’, E/e’ lateral, LAVI, and TR (p<0.05).
Conclusion: We conclude from this study that Type 2 diabetes is a risk factor for the development of left ventricular diastolic dysfunction and HFpEF. The burden of comorbid DM in HFpEF is rising, and thus it is necessary to target this population therapeutically. HFpEF is a multifactorial, clinically heterogeneous. Diagnosing HFpEF is challenging and relies upon the presence of symptoms and/or signs of heart failure, preserved left ventricular systolic function, and evidence of diastolic dysfunction. Current diagnostic algorithms mainly rely on echocardiography and biomarkers.