Myocardial dysfunction and chronic heart failure in patients with long-lasting type 1 diabetes: a 7-year prospective...

Area of Science:

• Cardiology
• Endocrinology
• Diabetology

Background:

• Type 1 diabetes (T1D) is a chronic condition requiring long-term management.
• Cardiovascular complications, including myocardial dysfunction (MD) and heart failure (HF), are significant concerns in T1D.
• Understanding the prevalence and incidence of MD and HF in T1D, especially with coexisting cardiovascular disorders, is crucial for patient care.

Purpose of the Study:

• To evaluate the prevalence and incidence of myocardial dysfunction (MD) and heart failure (HF) in patients with long-lasting type 1 diabetes (≥10 years).
• To investigate the occurrence of MD and HF in T1D patients with and without cardiovascular disorders (hypertension, coronary heart disease - CHD).

Main Methods:

• A cohort of 1,685 patients with type 1 diabetes (mean age 51, diabetes duration 36 years) was studied.
• Echocardiography, NT-proBNP measurement, and clinical evaluation were performed at baseline.
• A 7-year follow-up assessed systolic and diastolic MD and HF manifestations.

Main Results:

• Overall HF prevalence was 3.7% and incidence 0.02%/year; MD prevalence was 14.5% (incidence -0.1%/year).
• MD and HF were exclusively observed in patients with coexisting hypertension or CHD.
• Baseline predictors for HF included age, diabetes duration, HbA1c, CHD, elevated systolic blood pressure, and reduced GFR.

Conclusions:

• In type 1 diabetes, myocardial dysfunction and heart failure manifest primarily when associated with other cardiovascular disorders.
• The prevalence and incidence of HF in T1D patients with hypertension and CHD were notably low.
• Concomitant treatments may offer a cardioprotective effect, potentially explaining the low HF rates, though further research is needed.