PMID- 29405644
OWN - NLM
STAT- MEDLINE
DCOM- 20181217
LR  - 20220410
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 5
IP  - 3
DP  - 2018 Jun
TI  - Variations in subclinical left ventricular dysfunction, functional capacity, and 
      clinical outcomes in different heart failure aetiologies.
PG  - 343-354
LID - 10.1002/ehf2.12257 [doi]
AB  - AIMS: Patients with heart failure (HF) risk factors are described as being in 
      Stage A of this condition (SAHF). Management is directed towards prevention of HF 
      progression, but to date, no evidence has been described to align the intensity 
      of this intervention to HF risk. We sought to what extent SAHF of Type 2 diabetes 
      mellitus (T2DM) and other HF risks showed differences in subclinical left 
      ventricular function, exercise capacity, and prognosis. METHODS AND RESULTS: We 
      recruited 551 elder asymptomatic SAHF patients (age 71 +/- 5 years, 49% men, 290 
      T2DM) with at least one risk factor from a community-based population with 
      preserved ejection fraction. All underwent a comprehensive echocardiogram 
      including global longitudinal strain (GLS) and a 6 min walk test and were 
      followed for 2 years. The primary endpoints were new-onset HF and all-cause 
      mortality. The T2DM group was associated with reduced 6 min walk test distance 
      (451 +/- 111 vs. 493 +/- 87 m, P < 0.001), worse diastolic function (E/e' 9.2 +/- 2.7 
      vs. 8.7 +/- 2.4, P = 0.028), and impaired GLS (-17.7 +/- 2.6% vs. -19.0 +/- 2.6%, 
      P < 0.001). Over a median follow-up of 1.6 years, 49 T2DM-SAHF and 27 other-SAHF 
      met the primary endpoint. T2DM-SAHF had significantly worse outcome than 
      other-SAHF (P = 0.021). In Cox models, obesity [hazard ratio (HR) = 2.46; 
      P = 0.007], atrial fibrillation (HR = 2.39; P = 0.028), 6 min walk distance 
      (HR = 0.99; P = 0.034), and GLS (HR = 1.14; P = 0.033) were independently 
      associated with the primary endpoint in T2DM-SAHF, independent of age and 
      glycaemic control. CONCLUSIONS: The T2DM-SAHF has worse subclinical left 
      ventricular function, exercise capacity, and prognosis than other-SAHF. Impaired 
      GLS, atrial fibrillation, exercise capacity, and obesity are associated with a 
      worse prognosis in T2DM-SAHF but not in other-SAHF.
CI  - (c) 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Wang, Ying
AU  - Wang Y
AD  - Menzies Institute for Medical Research, Hobart, Australia.
FAU - Yang, Hong
AU  - Yang H
AD  - Menzies Institute for Medical Research, Hobart, Australia.
FAU - Nolan, Mark
AU  - Nolan M
AD  - Menzies Institute for Medical Research, Hobart, Australia.
FAU - Pathan, Faraz
AU  - Pathan F
AD  - Menzies Institute for Medical Research, Hobart, Australia.
FAU - Negishi, Kazuaki
AU  - Negishi K
AD  - Menzies Institute for Medical Research, Hobart, Australia.
FAU - Marwick, Thomas H
AU  - Marwick TH
AD  - Menzies Institute for Medical Research, Hobart, Australia.
AD  - Baker Heart and Diabetes Institute, Melbourne, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180205
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
SB  - IM
MH  - Aged
MH  - Diabetes Mellitus, Type 2/complications/physiopathology
MH  - Disease Progression
MH  - Echocardiography, Doppler
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Diastolic/complications/diagnosis/*physiopathology
MH  - Heart Failure, Systolic/complications/diagnosis/*physiopathology
MH  - Humans
MH  - Male
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stroke Volume/*physiology
MH  - Time Factors
MH  - Ventricular Dysfunction, Left/diagnosis/*etiology/physiopathology
MH  - Ventricular Function, Left/*physiology
MH  - Walk Test
PMC - PMC5933957
OTO - NOTNLM
OT  - 6 min walk
OT  - Diabetes mellitus
OT  - Global longitudinal strain
OT  - Heart failure
EDAT- 2018/02/07 06:00
MHDA- 2018/12/18 06:00
PMCR- 2018/02/05
CRDT- 2018/02/07 06:00
PHST- 2017/06/12 00:00 [received]
PHST- 2017/12/08 00:00 [revised]
PHST- 2017/12/17 00:00 [accepted]
PHST- 2018/02/07 06:00 [pubmed]
PHST- 2018/12/18 06:00 [medline]
PHST- 2018/02/07 06:00 [entrez]
PHST- 2018/02/05 00:00 [pmc-release]
AID - EHF212257 [pii]
AID - 10.1002/ehf2.12257 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2018 Jun;5(3):343-354. doi: 10.1002/ehf2.12257. Epub 2018 Feb 5.