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作为2型糖尿病中占主导地位和未被认可的心力衰竭表型的HFpEF:来自DIABET-IC研究的证据
P Gil-Millan1,2, J A Gimeno-Orna3, L Rodriguez-Padial4
1Hospital Universitari Vall d´Hebron, Barcelona, Spain. pedroalejandro.gil@vallhebron.cat.
Cardiovascular diabetology
|November 4, 2025
概括
保存喷射率心力衰竭 (HFpEF) 是2型糖尿病 (T2D) 患者中最常见的类型,其结果与减少喷射率心力衰竭 (HFrEF) 类似. 改善查和治疗对于这一群体至关重要.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 临床研究 临床研究
背景情况:
- 2型糖尿病 (T2D) 显著增加心力衰竭 (HF) 的风险.
- 保存喷射分数 (HFpEF) 的心力衰竭是T2D中占主导地位的HF表型.
- 在T2D中,HFpEF与HFrEF的临床特征,预后和治疗需要进一步阐明.
研究的目的:
- 为了比较T2D患者中HFpEF和HFrEF的临床概况,结果和管理策略.
- 评估T2D人口中这些HF表型的纵向进展和治疗模式.
主要方法:
- 对前性的全国性DIABET-IC队列研究的分析.
- 在西班牙58个中心包括1517名2型糖尿病患者,并对其进行了3年的跟踪.
- 使用2016年ESC指南分类的HF表型 (HFrEF,HFpEF,HFmrEF);评估基线特征,结果和治疗方法.
主要成果:
- 与HFrEF相比,HFpEF患者年龄较大,女性更频繁,肥胖,高血压和代谢综合征的发病率更高.
- HFrEF与缺血性心脏病和先前的心肌梗塞有关. 在HFpEF和HFrEF之间,死亡率相似.
- HFpEF是最频繁发生的HF表型;发现诊断不足,超过20%低于天然尿素的诊断值. HFrEF患者更经常接受指导方针导向治疗.
结论:
- HFpEF是T2D中最常见的HF表型,具有与HFrEF相似的结果,但往往被诊断不足和治疗不足.
- 加强查策略和更广泛地采用基于证据的治疗方法,特别是SGLT2抑制剂,对于在T2D中管理HFpEF至关重要.
- 该研究强调了需要改善高风险T2D人群中HFpEF的诊断和治疗方法.
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