Unit of Diabetes and Prevention of Associated Diseases, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JACC Heart Fail. 2015 Feb;3(2):136-45. doi: 10.1016/j.jchf.2014.08.004.
The prevalence of patients with concomitant heart failure (HF) and diabetes mellitus (DM) continues to increase with the general aging of the population. In patients with chronic HF, prevalence of DM is 24% compared with 40% in those hospitalized with worsening HF. Patients with concomitant HF and DM have diverse pathophysiologic, metabolic, and neurohormonal abnormalities that potentially contribute to worse outcomes than those without comorbid DM. In addition, although stable HF outpatients with DM show responses that are similar to those of patients without DM undergoing evidence-based therapies, it is unclear whether hospitalized HF patients with DM will respond similarly to novel investigational therapies. These data support the need to re-evaluate the epidemiology, pathophysiology, and therapy of HF patients with concomitant DM. This paper discusses the role of DM in HF patients and underscores the potential need for the development of targeted therapies.
随着人口普遍老龄化，合并心力衰竭（HF）和糖尿病（DM）的患者数量持续增加。在慢性 HF 患者中，DM 的患病率为 24%，而在 HF 恶化住院患者中则为 40%。合并 HF 和 DM 的患者存在多种病理生理、代谢和神经激素异常，这些异常可能导致预后比无合并 DM 的患者更差。此外，尽管接受基于证据的治疗的稳定 HF 门诊患者中 DM 患者的反应与无 DM 患者相似，但尚不清楚住院 HF 患者中 DM 患者对新型研究性治疗的反应是否相似。这些数据支持重新评估合并 DM 的 HF 患者的流行病学、病理生理学和治疗的必要性。本文讨论了 DM 在 HF 患者中的作用，并强调了开发针对性治疗方法的潜在需求。
