Horodinschi Ruxandra-Nicoleta, Diaconu Camelia Cristina
Department of Internal Medicine, University of Medicine and Pharmacy "Carol Davila" Bucharest, Romania.
Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest Bucharest, Romania.
Am J Cardiovasc Dis. 2021 Oct 25;11(5):564-575. eCollection 2021.
The objective of our study was to evaluate the severity of diastolic dysfunction in patients with heart failure with preserved ejection fraction (HFpEF), atrial fibrillation (AF) and type 2 diabetes mellitus (T2DM) compared to those with HFpEF and AF without DM.
This is an observational, prospective, case-control study. We selected 720 patients with heart failure consecutively admitted between March 2019-December 2020, of whom 253 patients with AF. After applying the inclusion/exclusion criteria, 105 subjects remained in the study. The patients were divided into two groups, according to the presence of T2DM: group A (39 patients with T2DM, 37.14%), group B (66 patients without T2DM, 62.85%). 2D transthoracic echocardiography was performed in all patients. The study was approved by the Ethics Committee of the hospital. Statistical analysis was performed using R software, version 4.0.2.
Patients with HFpEF, AF, and T2DM had higher LV filling pressures compared to those without DM (OR = 5.00, 95% CI: 1.77-15.19). Moreover, patients with insulin-requiring T2DM (OR = 6.25, 95% CI: 1.50-25.98) had higher LV filling pressures than those treated with oral antidiabetic drugs (OR = 4.44, 95% CI: 1.37-15.17). We demonstrated that patients with T2DM had higher E/e' ratio (difference -2.78, P 0.0003, 95% CI: -4.24 to -1.31) and lower deceleration time (DT) (difference 23.04, P 0.0002, 95% CI: 11.10-34.97) than those without T2DM.
Patients with HFpEF, AF and T2DM have higher LV filling pressures than those without T2DM, suggesting that the presence of T2DM leads to a more severe diastolic dysfunction.
我们研究的目的是评估射血分数保留的心力衰竭（HFpEF）、心房颤动（AF）和2型糖尿病（T2DM）患者与无糖尿病的HFpEF和AF患者相比舒张功能障碍的严重程度。
这是一项观察性、前瞻性病例对照研究。我们连续选取了2019年3月至2020年12月期间收治的720例心力衰竭患者，其中253例患有AF。应用纳入/排除标准后，105名受试者纳入研究。根据是否存在T2DM将患者分为两组：A组（39例T2DM患者，占37.14%），B组（66例无T2DM患者，占62.85%）。所有患者均进行了二维经胸超声心动图检查。该研究获得了医院伦理委员会的批准。使用R软件4.0.2版进行统计分析。
与无糖尿病患者相比，HFpEF、AF和T2DM患者的左心室充盈压更高（比值比=5.00，95%置信区间：1.77 - 15.19）。此外，需要胰岛素治疗的T2DM患者（比值比=6.25，95%置信区间：1.50 - 25.98）的左心室充盈压高于接受口服降糖药治疗的患者（比值比=4.44，95%置信区间：1.37 - 15.
