Current status on the therapeutic strategies for heart failure and diabetic cardiomyopathy

Amy Hyein Kim1, Jung Eun Jang2, Jin Han1

  • 1Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Smart Marine Therapeutics Center, Inje University, Busan 47392, South Korea; Department of Health Sciences and Technology, Graduate School, Inje University, Busan 47392, South Korea.

Insights

Heart failure (HF) survival is poor, especially for those with type 2 diabetes mellitus (T2DM). This review covers updated treatments for heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), and their link to diabetes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Diabetology

Background:

  • Heart failure (HF) is a major cause of cardiovascular death, with high mortality rates.
  • Type 2 diabetes mellitus (T2DM) significantly increases the risk of developing HF.
  • Global prevalence of both diabetes and HF continues to rise, necessitating updated management strategies.

Purpose of the Study:

  • To provide an overview of current heart failure (HF) management.
  • To discuss treatments for both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).
  • To explore the relationship between HF, T2DM, and diabetic cardiomyopathy, including therapeutic approaches.

Main Methods:

  • This is a review article.
  • Literature search on current HF guidelines and T2DM comorbidities.
  • Synthesis of information on HF subtypes and diabetes-related cardiac complications.

Main Results:

  • Heart failure remains a critical condition with significant mortality.
  • T2DM is a major risk factor for HF development and progression.
  • Emerging therapeutic strategies address both HF and T2DM concurrently.

Conclusions:

  • Updated treatment protocols for HFrEF and HFpEF are crucial.
  • Understanding the interplay between T2DM and HF is vital for effective patient care.
  • Integrated therapeutic approaches are needed for patients with comorbid HF and diabetes.

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
46
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
561
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
52
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
523
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
63
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
816