Health status in stage B heart failure from diabetic cardiomyopathy baseline results from ARISE-HF
Tariq Jamal Siddiqi1, Yuxi Liu2, Faiez Zannad3
1Department of Medicine, Baylor University Medical Center, Dallas, TX, USA.
Insights
Health status in diabetic cardiomyopathy (DbCM) is often poor. While linked to exercise capacity and activity, patient-reported outcomes show weak correlations with objective measures, suggesting unique insights from each assessment.
Area of Science:
- Cardiology
- Diabetology
- Internal Medicine
Background:
- Diabetic cardiomyopathy (DbCM) is a significant complication of diabetes, leading to heart failure.
- The ARISE-HF trial (NCT04083339) investigated DbCM.
- Understanding health status determinants in DbCM is crucial for management.
Purpose of the Study:
- To assess health status determinants in individuals with diabetic cardiomyopathy (DbCM).
- To evaluate the correlation between patient-reported health status and objective clinical parameters in DbCM.
Main Methods:
- The study analyzed data from 691 participants in the ARISE-HF trial.
- Assessments included the Kansas City Cardiomyopathy Questionnaire (KCCQ), cardiopulmonary exercise testing (CPET), Physical Activity Scale for the Elderly (PASE), echocardiography, and laboratory tests.
- Baseline data were used for the analysis.
Main Results:
- Lower KCCQ-Clinical Summary Scores (CSS) were associated with female sex, poorer kidney function, higher BMI, elevated natriuretic peptides, and lower hemoglobin.
- Worse KCCQ-CSS showed weak correlations with shorter CPET duration, lower peak VO₂, and lower PASE scores.
- No significant associations were found between KCCQ-CSS and echocardiographic measures, cardiac biomarkers, or kidney function.
Conclusions:
- Health status is frequently impaired in Stage B heart failure due to DbCM.
- The KCCQ shows only weak correlations with CPET and PASE scores in DbCM patients.
- These findings suggest that KCCQ, CPET, and PASE provide distinct and complementary information on patient status.
Aims:
Assess the determinants of health status and its correlation with key parameters in individuals with diabetic cardiomyopathy (DbCM).
Methods:
In the ARISE-HF trial, the Kansas City Cardiomyopathy Questionnaire (KCCQ), cardiopulmonary exercise testing (CPET), Physical Activity Scale for the Elderly (PASE) score, echocardiographic, and laboratory assessments were performed at baseline in 691 persons with DbCM.
Results:
Study participants with lower KCCQ-Clinical Summary Score (CSS) were predominantly women, had poorer kidney function, higher body-mass index and natriuretic peptides, and lower hemoglobin levels. Lower KCCQ-CSS scores were associated with shorter CPET duration, lower peak exercise oxygen consumption (VO₂) and lower PASE scores, but the correlations were weak (CPET duration: r = 0.14, 95 % CI: 0.07-0.22; peak VO₂: r = 0.21, 95 % CI: 0.14-0.28; PASE score: r = 0.19, 95 % CI: 0.11-0.26), indicating that although worse health status was linked to poorer function and activity, the strength of these relationships was limited. No meaningful associations were observed between KCCQ-CSS and echocardiographic measurements, cardiac biomarkers, or kidney function.
Conclusion:
Health status in Stage B heart failure due to DbCM is frequently impaired. Among those with DbCM the KCCQ is only weakly correlated with the CPET parameters and PASE score implying these assessments provide unique information.
Trial Registration:
ARISE-HF, NCT04083339.
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