The characteristics of heart failure in patients with diabetes mellitus in Sanglah Hospital Denpasar

Anak Agung Ketut Yunita Paramita; Made Ratna Saraswati; Nyoman Wiryawan

doi:10.36216/jpd.v5i2.152

Authors

Anak Agung Ketut Yunita Paramita Internal Medicine Resident, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
Made Ratna Saraswati Internal Medicine Department, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
Nyoman Wiryawan Cardiology and Vascular Medicine Department, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.36216/jpd.v5i2.152

Keywords:

Echocardiography, heart failure, diabetic cardiomyopathy

Abstract

Background: The prevalence of heart failure (HF) is 4 times higher in patients with diabetes mellitus (DM) than general population. Coronary heart disease (CHD), hypertension, DM, obesity, smoking and atrial fibrillation are risk factors for HF. However, many observational studies have shown that DM is an independent risk factor for HF through the mechanism of diabetic cardiomyopathy.

Objective: This study aimed to determine the characteristic heart failure in patients with DM.

Methods: This study used a cross sectional descriptive design and the secondary data originating from medical records of patient in the intermediate ward and intensive care coronary care unit, Sanglah Hospital on March 2020 - March 2021. The inclusion criteria were DM patients with acute or chronic HF, while the exclusions criteria were DM patients with anemia, pregnancy and incomplete medical record data.

Result: A total of 65 subjects were male (43%), aged > 60 years (52.3%), had a history of smoking (50.8%), experienced obesity grade I (35.4), with duration of DM > 5 years (67.7%) and had poor glycemic control (55.4%). The majority of DM complications were CHD (86.2%). Based on echocardiography results, the subjects had heart failure with reduced ejection fraction (43.1%), left atrial dilatation (58.5%), left ventricular hypertrophy (80%), heart valve abnormalities (66.2%) and left ventricular diastolic dysfunction (73.8%).

Conclusion: There were no subjects who only suffered from DM type 2 without other comorbid diseases such as CHD, hypertension or heart valve disease.

Downloads

Download data is not yet available.

Author Biographies

Anak Agung Ketut Yunita Paramita, Internal Medicine Resident, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia

Internal Medicine Resident, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
Made Ratna Saraswati, Internal Medicine Department, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia

Internal Medicine Department, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
Nyoman Wiryawan, Cardiology and Vascular Medicine Department, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia

Cardiology and Vascular Medicine Department, Faculty of Medicine of Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia

References

Ponikowski P, Voors AA, Anker SD, dkk. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European heart journal. 2016;37(27):2129-2200.

Wilkinson MJ, Zadourian A, Taub PR. Heart failure and diabetes mellitus: defining the problem and exploring the interrelationship. The American journal of cardiology. 2019;124:S3-11.

Buddeke J, Valstar GB, van Dis I, dkk. Mortality after hospital admission for heart failure: improvement over time, equally strong in women as in men. BMC public health. 2020;20(1):1-10.

Groenewegen A, Rutten FH, Mosterd A, dkk. Epidemiology of heart failure. European journal of heart failure. 2020;22(8):1342-1356.

Dunlay SM, Weston SA, Jacobsen SJ, dkk. Risk factors for heart failure: a population-based case-control study. The American journal of medicine. 2009;122(11):1023-1028.

Lawson CA, Zaccardi F, Squire I, dkk. Risk factors for heart failure: 20-year population-based trends by sex, socioeconomic status, and ethnicity. Circulation: Heart Failure. 2020;13(2):e006472.

Dunlay SM, Givertz MM, Aguilar D, dkk. Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update. Circulation. 2019;140(7):e294-e324.

Rosano GM, Vitale C, Seferovic P. Heart failure in patients with diabetes mellitus. Cardiac failure review. 2017;3(1):52.

Maack C, Lehrke M, Backs J, dkk. Heart failure and diabetes: metabolic alterations and therapeutic interventions: a state-of-the-art review from the Translational Research Committee of the Heart Failure Association–European Society of Cardiology. European heart journal. 2018;39(48):4243-4254.

Cefalu WT, Kaul S, Gerstein HC, dkk. Cardiovascular outcomes trials in type 2 diabetes: where do we go from here? Reflections from a diabetes care editors’ expert forum. Diabetes care. 2018;41(1):14-31.

Kenny HC, Abel ED. Heart failure in type 2 diabetes mellitus: impact of glucose-lowering agents, heart failure therapies, and novel therapeutic strategies. Circulation research. 2019;124(1):121-141.

Gassanov N, Raghavan M, Mutallimov M, dkk. Diabetic cardiomyopathy: pathogenesis and clinical implications. The Cardiologist. 2017;1(1):10-19.

Borghetti G, von Lewinski D, Eaton DM, dkk. Diabetic cardiomyopathy: current and future therapies. Beyond glycemic control. Frontiers in physiology. 2018;9:1514.

Laakso M. Heart in diabetes: a microvascular disease. Diabetes care. 2011;34(Supplement 2):S145-S149.

Zimmerman RS. Diabetes mellitus: management of microvascular and macrovascular complications. J Cleveland Clinic: Centers for Continuing Education.. 2016. [Available at: https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/diabetes-mellitus/].

Nichols GA, Gullion CM, Koro CE, dkk. The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes care. 2004;27(8):1879-1884.

Cosentino F, Grant PJ, Aboyans V, dkk. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). European heart journal. 2020;41(2):255-323.

Roumie CL, Min JY, D'Agostino McGowan L, dkk. Comparative safety of sulfonylurea and metformin monotherapy on the risk of heart failure: a cohort study. Journal of the American Heart Association. 2017;6(4):e005379.

Bernardi S, Michelli A, Zuolo G, dkk. Update on RAAS modulation for the treatment of diabetic cardiovascular disease. Journal of diabetes research. 2016;2016: 8917578.

Ferrario CM. Cardiac remodelling and RAS inhibition. Therapeutic advances in cardiovascular disease. 2016;10(3):162-171.

Soelistijo SA, Lindarto D, Deocroli E, dkk. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2. Jakarta: PB Perkeni; 2019.

Low Wang CC, Hess CN, Hiatt WR, dkk. Clinical update: cardiovascular disease in diabetes mellitus: atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus–mechanisms, management, and clinical considerations. Circulation. 2016;133(24):2459-2502.

Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nature Reviews Cardiology. 2016;13(6):368-378.

Negishi K. Echocardiographic feature of diabetic cardiomyopathy: where are we now?. Cardiovascular diagnosis and therapy. 2018;8(1):47.

Mandras SA, Desai S. Right Heart Failure. [Updated 2021 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. [Available at: https://www.ncbi.nlm.nih.gov/books/NBK459381/]

Khan TA, Chowdhury AW, Khan HL, dkk. Echocardiographic comparison of regional wall motion abnormality between patients with acute anteroseptal and acute extensive anteior ST segment elevation myocardial infarction. Bangladesh Medical Research Council Bulletin. 2015;41(1):35-40.