The profile of heart failure in women with diabetes mellitus and anemia

Introduction: The overall prevalence of heart failure is similar in both genders, but women are more likely to be diagnosed late, leading to a worse long term progno-sis. Diabetes mellitus (DM) often plays a role in the un-favourable evolution of heart failure in female patients. Objective: To analyse the profile features of heart failu-re women with concomitant DM.
Methods: 96 women previously diagnosed with symp-tomatic heart failure were enrolled in the study, 43.01% of which were diabetic, while the rest of 57.14% had euglycemia. Heart failure was defined accor-ding to the 2016 ESC criteria. All subjects were evalua-ted for associated cardiovascular risk factors, NT-pro-BNP levels and by echocardiography.Results: There was no difference regarding the age of the patients: 70.02±8.11 vs. 72.61±11.76 years. Overall median NT-pro-BNP value was elevated (2479.9±2669 pg/ml), without any significant difference between the two groups: 2711±2828 pg/ml for diabetic women, and 2284±2538 pg/ml for non-diabetic. Mean ejection frac-tion was 49.23±8.8%. There was no statistical difference related to the presence or absence of DM: 47.83±8.71 vs.50.41±8.79% (p=NS). These variations failed to re-ach statistical significance even after adjusting for LV ejection fraction category: ≥50% (65.11 vs. 76.47%), 40-49% (32.43 vs. 25.64%) or <40% (32.43 vs. 15.38%). The patients of both groups had an ejection fraction of more than 50%, meaning that most patients had heart failure with a preserved ejection fraction. There was an overall indirect correlation between NT-pro-BNP levels and ejection fraction: Spearman\›s coefficient of rank correlation (rho) – 0.239, p=0.0214. Nonetheless, if for the diabetes group this correlation is statistically significant (-0.437, p=0.0047), in non-diabetic women it fails to reach statistical significance (-0.0597, p=NS). NT-pro BNP levels were higher in diabetic women with anemia compared to those without: 4367.91 vs. 2090.03 pg/ml (p=0.015). This relationship was not found in non-diabetic women: 2926.975 vs. 2776.92 pg/ml (p=NS).
Conclusions: Determinants of NT-pro-BNP values were only ejection fraction (p=0.0075) and haemoglo-bin levels (p=0.04), in the diabetes group, and end-di-astolic LV volume (p=0.0089) and total cholesterol le-vels (p=0.017), in nondiabetic patients. In conclusion, women with heart failure and concomitant DM exhibit certain particularities that may prove important in the management of this condition.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)