Diabetes Mellitus May Increase Risk for Developing Heart Failure

Patients with diabetes mellitus have an increased risk for heart failure, even in the absence of diastolic dysfunction, according to a study published in the January issue of the Mayo Clinic Proceedings.

Michael D. Klajda, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues identified 116 participants with DM and 232 without DM, aged 45 years and older, from the Rochester Epidemiology Project to examine the impact of DM on the development of cardiovascular diseases in a community population.

The researchers found that the E/e' ratio was higher in DM versus non-DM participants (9.7 versus 8.5), while left ventricular ejection fractions were similar. Participants with DM had an increased incidence of heart failure during 10.8 months of follow-up (hazard ratio, 2.1; 95 percent confidence limits, 1.2 to 3.6; P = 0.01) and a 10-year Kaplan-Meier rate of 21 percent compared with 12 percent among those without DM. In a subgroup of participants without diastolic dysfunction, those with DM had an elevated risk for heart failure (hazard ratio, 2.5; 95 percent confidence limits, 1.0 to 6.3; P = 0.04).

"The findings in this report support the concept of diabetic cardiomyopathy," the authors write. "Future research should be focused on whether aggressive management of risk factors such as body mass index and glucose and cholesterol levels will decrease the development of heart failure in patients with DM."

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