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Updated: Jul 4, 2025
Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
Published on: November 29, 2024
Characterizing diabetic cardiomyopathy: baseline results from the ARISE-HF trial
James L Januzzi1,2, Stefano Del Prato3, Julio Rosenstock4
1Heart Failure Trials, Baim Institute for Clinical Research, Boston, MA, USA. jjanuzzi@partners.org.
Insights
Diabetic cardiomyopathy (DbCM) is a stage B heart failure risk. Baseline data from the ARISE-HF trial characterize individuals with type 2 diabetes mellitus and DbCM features, aiding diagnosis.
Area of Science:
- Cardiology
- Endocrinology
- Heart Failure Research
Background:
- Diabetic cardiomyopathy (DbCM) represents Stage B heart failure (HF), carrying a high risk of progression.
- Understanding DbCM's clinical profile is crucial for early intervention and management.
Purpose of the Study:
- To characterize the clinical features of individuals with findings consistent with DbCM.
- To leverage baseline data from the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) Trial.
Main Methods:
- Analysis of clinical characteristics, laboratory tests, and imaging from ARISE-HF participants.
- Utilized Kansas City Cardiomyopathy Questionnaire (KCCQ), Physical Activity Scale of the Elderly (PASE), and cardiopulmonary exercise testing (CPET).
- Employed K-means clustering to identify distinct patient phenogroups.
Main Results:
- Study included 691 participants (mean age 67.4 years, 50% female) with a mean 14.5-year duration of type 2 diabetes mellitus (T2DM).
- Common echocardiographic findings included reduced global longitudinal strain (25.3%) and impaired diastolic relaxation (17.7%).
- Identified 4 phenogroups, with one higher-risk group exhibiting advanced age, elevated cardiac biomarkers, and diastolic dysfunction/left ventricular hypertrophy.
Conclusions:
- Baseline ARISE-HF data offer valuable clinical characterization of T2DM patients with Stage B HF features.
- These findings may contribute to clarifying the diagnosis and management of diabetic cardiomyopathy.
Background:
Diabetic cardiomyopathy (DbCM) is a form of Stage B heart failure (HF) at high risk for progression to overt disease. Using baseline characteristics of study participants from the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) Trial we sought to characterize clinical characteristics of individuals with findings consistent with DbCM.
Methods:
Among study participants meeting inclusion criteria, clinical characteristics, laboratory testing, imaging, Kansas City Cardiomyopathy Questionnaire (KCCQ), Physical Activity Scale of the Elderly (PASE) and cardiopulmonary exercise testing (CPET) results were tabulated. Cluster phenogroups were identified.
Results:
Among 691 study participants (mean age 67.4 years; 50% were female), mean duration of type 2 diabetes mellitus (T2DM) was 14.5 years. The median (Q1, Q3) N-terminal pro-B type natriuretic peptide and high sensitivity cardiac troponin T were 71 (35, 135) ng/L and 9 [6, 12] ng/L. The most common echocardiographic abnormalities were reduced global longitudinal strain in 25.3% and impaired diastolic relaxation in 17.7%. Despite rather well-preserved KCCQ scores the average PASE score was markedly impaired at 155 accompanied by an average maximal oxygen consumption of 15.7 mL/Kg/minute on CPET. In K-means clustering, 4 phenogroups were identified including a higher-risk group with more advanced age, greater elevation of cardiac biomarkers, and more prevalent evidence for diastolic dysfunction and left ventricular hypertrophy.
Conclusions:
Baseline data from the ARISE-HF Trial provide clinical characterization of individuals with T2DM and features of stage B HF, and may help clarify the diagnosis of DbCM.
Trial Registration:
ARISE-HF, NCT04083339.
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