Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial
Abstract Background Diabetic myocardial disorder (DbMD, evidenced by abnormal echocardiography or cardiac biomarkers) is a form of stage B heart failure (SBHF) at high risk for progression to overt HF. SBHF is defined by abnormal LV morphology and function and/or abnormal cardiac biomarker concentra...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-024-02554-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832594975338004480 |
|---|---|
| author | Thomas H. Marwick Carolyn Lam Yuxi Liu Stefano Del Prato Julio Rosenstock Javed Butler Justin Ezekowitz Nasrien E. Ibrahim W. H. Wilson Tang Faiez Zannad Riccardo Perfetti James L. Januzzi |
| author_facet | Thomas H. Marwick Carolyn Lam Yuxi Liu Stefano Del Prato Julio Rosenstock Javed Butler Justin Ezekowitz Nasrien E. Ibrahim W. H. Wilson Tang Faiez Zannad Riccardo Perfetti James L. Januzzi |
| author_sort | Thomas H. Marwick |
| collection | DOAJ |
| description | Abstract Background Diabetic myocardial disorder (DbMD, evidenced by abnormal echocardiography or cardiac biomarkers) is a form of stage B heart failure (SBHF) at high risk for progression to overt HF. SBHF is defined by abnormal LV morphology and function and/or abnormal cardiac biomarker concentrations. Objective To compare the evolution of four DbMD groups based on biomarkers alone, systolic and diastolic dysfunction alone, or their combination. Methods The Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial was a Phase 3 randomised trial of an aldose reductase inhibitor in patients with well-controlled type 2 diabetes mellitus (T2DM). The 1858 potential participants (age 67 ± 7 years; 50% women) were screened for SBHF based on abnormal echocardiography or biomarkers (N-terminal pro-B-type natriuretic peptide ≥ 40 ng/L or high sensitivity cardiac troponin T ≥ 10 ng/L [women] and ≥ 16 ng/L [men]). Exercise capacity (peak VO2) was reduced in 669 with DbMD (age 68 ± 7, 50% women), and peak VO2 was reassessed at 15 months. Results The 1463 (79%) participants with DbMD were allocated to four clusters; 907 (49%) showed isolated elevation of cardiac biomarkers, 301 (16%) with systolic dysfunction/hypertrophy, 162 (9%) with diastolic dysfunction and 93 (5%) comprised an overlap cluster (combined diastolic, systolic or LV geometric abnormalities). Reduced VO2 (< 75% predicted) was present in 669 (46%); 72% of those with both systolic and diastolic dysfunction, 56% of those with systolic dysfunction and LVH, 53% of those with diastolic dysfunction and 38% with biomarkers alone (p < 0.0001). In 669 patients followed over 15 months, there was a similar small decrement in VO2 in all groups. Conclusions Among individuals with T2DM and SBHF, reduced functional capacity is most prevalent in those with multiple physiological disturbances. However, there was no difference between phenogroups in the evolution of exercise intolerance. Trial Registration: ARISE-HF, NCT04083339. |
| format | Article |
| id | doaj-art-69cd8eebcd0e41b9be9fefe255f8e5a0 |
| institution | Kabale University |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-69cd8eebcd0e41b9be9fefe255f8e5a02025-01-19T12:09:08ZengBMCCardiovascular Diabetology1475-28402025-01-0124111110.1186/s12933-024-02554-yEchocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trialThomas H. Marwick0Carolyn Lam1Yuxi Liu2Stefano Del Prato3Julio Rosenstock4Javed Butler5Justin Ezekowitz6Nasrien E. Ibrahim7W. H. Wilson Tang8Faiez Zannad9Riccardo Perfetti10James L. Januzzi11Baker Heart and Diabetes Institute, Melbourne and Menzies Institute for Medical ResearchNational Heart Centre Singapore and Duke-National University of SingaporeCardiology Division, Massachusetts General Hospital, Harvard Medical SchoolInterdisciplinary Research Center “Health Science”, Sant’Anna School of Advanced StudiesSouthwestern Medical Center, Velocity Clinical Research at Medical City and University of TexasBaylor Scott and White Research InstituteCanadian VIGOUR Centre, University of AlbertaCardiology Division, Brigham and Women’s Hospital, Harvard Medical SchoolDepartment of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland ClinicApplied Therapeutics Inc.CIC Inserm and CHRU Nancy, Université de LorraineCardiology Division, Massachusetts General Hospital, Harvard Medical SchoolAbstract Background Diabetic myocardial disorder (DbMD, evidenced by abnormal echocardiography or cardiac biomarkers) is a form of stage B heart failure (SBHF) at high risk for progression to overt HF. SBHF is defined by abnormal LV morphology and function and/or abnormal cardiac biomarker concentrations. Objective To compare the evolution of four DbMD groups based on biomarkers alone, systolic and diastolic dysfunction alone, or their combination. Methods The Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial was a Phase 3 randomised trial of an aldose reductase inhibitor in patients with well-controlled type 2 diabetes mellitus (T2DM). The 1858 potential participants (age 67 ± 7 years; 50% women) were screened for SBHF based on abnormal echocardiography or biomarkers (N-terminal pro-B-type natriuretic peptide ≥ 40 ng/L or high sensitivity cardiac troponin T ≥ 10 ng/L [women] and ≥ 16 ng/L [men]). Exercise capacity (peak VO2) was reduced in 669 with DbMD (age 68 ± 7, 50% women), and peak VO2 was reassessed at 15 months. Results The 1463 (79%) participants with DbMD were allocated to four clusters; 907 (49%) showed isolated elevation of cardiac biomarkers, 301 (16%) with systolic dysfunction/hypertrophy, 162 (9%) with diastolic dysfunction and 93 (5%) comprised an overlap cluster (combined diastolic, systolic or LV geometric abnormalities). Reduced VO2 (< 75% predicted) was present in 669 (46%); 72% of those with both systolic and diastolic dysfunction, 56% of those with systolic dysfunction and LVH, 53% of those with diastolic dysfunction and 38% with biomarkers alone (p < 0.0001). In 669 patients followed over 15 months, there was a similar small decrement in VO2 in all groups. Conclusions Among individuals with T2DM and SBHF, reduced functional capacity is most prevalent in those with multiple physiological disturbances. However, there was no difference between phenogroups in the evolution of exercise intolerance. Trial Registration: ARISE-HF, NCT04083339.https://doi.org/10.1186/s12933-024-02554-yDiabetic myocardial disorderBiomarkersSystolic dysfunctionDiastolic dysfunction |
| spellingShingle | Thomas H. Marwick Carolyn Lam Yuxi Liu Stefano Del Prato Julio Rosenstock Javed Butler Justin Ezekowitz Nasrien E. Ibrahim W. H. Wilson Tang Faiez Zannad Riccardo Perfetti James L. Januzzi Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial Cardiovascular Diabetology Diabetic myocardial disorder Biomarkers Systolic dysfunction Diastolic dysfunction |
| title | Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial |
| title_full | Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial |
| title_fullStr | Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial |
| title_full_unstemmed | Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial |
| title_short | Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial |
| title_sort | echocardiographic phenotypes of diabetic myocardial disorder evolution over 15 months follow up in the arise hf trial |
| topic | Diabetic myocardial disorder Biomarkers Systolic dysfunction Diastolic dysfunction |
| url | https://doi.org/10.1186/s12933-024-02554-y |
| work_keys_str_mv | AT thomashmarwick echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT carolynlam echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT yuxiliu echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT stefanodelprato echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT juliorosenstock echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT javedbutler echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT justinezekowitz echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT nasrieneibrahim echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT whwilsontang echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT faiezzannad echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT riccardoperfetti echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial AT jamesljanuzzi echocardiographicphenotypesofdiabeticmyocardialdisorderevolutionover15monthsfollowupinthearisehftrial |