Lehrke Michael, Marx Nikolaus
Department of Internal Medicine I, University Hospital Aachen, Germany.
Department of Internal Medicine I, University Hospital Aachen, Germany.
Am J Cardiol. 2017 Jul 1;120(1S):S37-S47. doi: 10.1016/j.amjcard.2017.05.014. Epub 2017 May 30.
Epidemiologic and clinical data from the last 2 decades have shown that the prevalence of heart failure in diabetes is very high, and the prognosis for patients with heart failure is worse in those with diabetes than in those without diabetes. Experimental data suggest that various mechanisms contribute to the impairment in systolic and diastolic function in patients with diabetes, and there is an increased recognition that these patients develop heart failure independent of the presence of coronary artery disease or its associated risk factors. In addition, current clinical data demonstrated that treatment with the sodium glucose cotransporter 2 inhibitor empagliflozin reduced hospitalization for heart failure in patients with type 2 diabetes mellitus and high cardiovascular risk. This review article summarizes recent data on the prevalence, prognosis, pathophysiology, and therapeutic strategies to treat patients with diabetes and heart failure.
过去20年的流行病学和临床数据表明,糖尿病患者中心力衰竭的患病率非常高,与非糖尿病患者相比,糖尿病合并心力衰竭患者的预后更差。实验数据表明,多种机制导致糖尿病患者的收缩和舒张功能受损,并且人们越来越认识到这些患者发生心力衰竭与冠状动脉疾病或其相关危险因素无关。此外,目前的临床数据表明,使用钠-葡萄糖协同转运蛋白2抑制剂恩格列净治疗可降低2型糖尿病和高心血管风险患者因心力衰竭住院的几率。这篇综述文章总结了有关糖尿病合并心力衰竭患者的患病率、预后、病理生理学和治疗策略的最新数据。