Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.
Lancet Diabetes Endocrinol. 2023 Aug;11(8):607-624. doi: 10.1016/S2213-8587(23)00128-6. Epub 2023 Jun 26.
The burden of heart failure among people with type 2 diabetes is increasing globally. People with comorbid type 2 diabetes and heart failure often have worse outcomes than those with only one of these conditions-eg, higher hospitalisation and mortality rates. Therefore, it is essential to implement optimal heart failure prevention strategies for people with type 2 diabetes. A detailed understanding of the pathophysiology underlying the occurrence of heart failure in type 2 diabetes can aid clinicians in identifying relevant risk factors and lead to early interventions that can help prevent heart failure. In this Review, we discuss the pathophysiology and risk factors of heart failure in type 2 diabetes. We also review the risk assessment tools for predicting heart failure incidence in people with type 2 diabetes as well as the data from clinical trials that have assessed the efficacy of lifestyle and pharmacological interventions. Finally, we discuss the potential challenges in implementing new management approaches and offer pragmatic recommendations to help overcome these challenges.
全球范围内，患有 2 型糖尿病的人群中心力衰竭的负担正在增加。患有 2 型糖尿病合并心力衰竭的人群往往比仅有一种疾病的人群预后更差，例如住院率和死亡率更高。因此，对于 2 型糖尿病患者实施最佳心力衰竭预防策略至关重要。深入了解 2 型糖尿病患者心力衰竭发生的病理生理学机制可以帮助临床医生识别相关风险因素，并进行早期干预，有助于预防心力衰竭。在这篇综述中，我们讨论了 2 型糖尿病心力衰竭的病理生理学和危险因素。我们还回顾了用于预测 2 型糖尿病患者心力衰竭发生率的风险评估工具，以及评估生活方式和药物干预疗效的临床试验数据。最后，我们讨论了实施新管理方法的潜在挑战，并提供了切实可行的建议以帮助克服这些挑战。
