IMPACT OF DIABETES MELLITUS ON PROGRESSION OF HEART FAILURE WITH PRESERVED EJECTION FRACTION (HFPEF)
Main Article Content
Keywords
Diabetes Mellitus, HFpEF, Myocardial Stiffness, Diastolic Dysfunction
Abstract
Background:Diabetes mellitus (DM) is among the principal risk factors related to cardiovascular disease, heart failure with preserved ejection fraction (HFpEF). HFpEF is typified by defective myocardial relaxation and diastolic heart dysfunction, causing heart failure symptoms with normal ejection fraction. The correlation between DM and HFpEF development has not properly studied in Pakistan which has the highest age correlated prevalence of diabetes in the world. The proposed study will evaluate the effects of DM in the progression of HFpEF with regard to myocardial stiffness, diastolic performance, and clinical outcome.
Objectives:To assess the impact of diabetes mellitus on the development of HFpEF, including myocardial stiffness, diastolic dysfunction, and patient outcomes in a 12-month follow-up.
Methodology:A prospective study was carried out among 100 HFpEF patients (who were split into two categories: 60 patients with DM and 40 patients without DM). At baseline and 12 months, clinical data, such as echocardiographies (left ventricular diastolic function, ejection fraction), HbA1c, and inflammatory markers, were measured. Myocardial stiffness parameters were measured with the help of tissue Doppler imaging (TDI) and functional measurements, such as exercise capacity (6-minute walk test) and hospitalizations. Paired t-tests and chi-square tests of categorical variables were used to conduct statistical analysis.
Results:The mean age of participants was 68.5 years (SD = 7.4). Diabetic patients exhibited significantly higher myocardial stiffness (p < 0.01) and worse diastolic dysfunction, with an E/e' ratio of 14.2 (SD = 2.8) versus 11.8 (SD = 2.3) in non-diabetics (p < 0.05). Diabetic patients had reduced 6-minute walk test performance (350m vs. 410m, p < 0.01), and higher hospitalization rates (18 vs. 8, p = 0.04). Poorer glycemic control (HbA1c levels) correlated with worse functional outcomes (r = -0.45, p < 0.01).
Conclusion:The HFpEF progression in diabetes mellitus is notably aggravated, which leads to greater myocardial stiffness, diastolic dysfunction, and worse clinical outcomes. Glycemic control is critical in enhancing patient outcomes.
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Muhammad Faheem khan
Associate Professor, Cardiology unit, Khyber Medical College. Peshawar
Farooq Ahmad
Associate Professor, Cardiology unit, Khyber Medical College, Peshawar
Awais Farhad
Assistant Professor, Cardiology unit, Khyber Medical College, Peshawar.
Muhammad Habeel Dar
Senior Registrar, Cardiology unit, Khyber Teaching Hospital, Peshawar.
Zeeshan Ahmad
PG resident, Cardiology unit, Khyber Teaching Hospital, Peshawar.
Kamran khan
PG resident, Cardiology unit, Khyber Teaching Hospital, Peshawar.
