The influence of a pre diabetic metabolic situation and diabetes mellitus type II on the development of heart failure in the curse of ten years

It is known that a prediabetic metabolism has a negative impact on the progression of heart failure and increases the risk of cardiovascular disease; however, available epidemiological data is divergent. Therefore, in this post-hoc analysis, based on the data from the DIAST-CHF study, the question should be investigated whether a prediabetic or diabetic metabolic situation influences the progression of heart failure. The primary objective of the study was to evaluate the prevalence and course of the disease of subjects with diastolic dysfunction or manifest heart failure in a group with cardiovascular risk factors. The participants aged 50-85 years (n = 1660) were divided into a group with diastolic dysfunction without clinical signs of heart failure and a group with clinically manifest heart failure. The evaluation of the study results showed that patients with prediabetes were six times more likely to develop manifiable type II diabetes over a period of 10 years. The HbA1c values ​​rose on average by 2%, regardless of whether the changed metabolic situation was treated or not. In the group that developed prediabetes at the end of the study, the average HbA1c value was 6.3% (n = 22), in the group with non-insulin-dependent diabetes mellitus 7.1% (n = 75 ) and in the group with diabetes requiring insulin at 7.5% (n = 35). Cardiovascular events such as heart attacks, strokes and ischemic attacks only occurred in 3.5% of the study participants in the 10-year follow-up period without an increased probability in one of the four groups mentioned (p = 0.643 ). Echocardiographic control examinations showed an increase in the rear wall thickness of 0.55 mm (95% CI 0.4-0.69 p 0.001). The increase in the thickness of the rear wall increased significantly in the two upper HbA1c quartiles compared to the first quartile (0.4 mm in the third quartile, 95% CI 0.04-0.8, p = 0.029, and 0 in the fourth quartile) , 43 mm, 95% CI 0.04-0.8, p = 0.032), while there was no significant difference between the first and second quartile (p = 0.856). These results show a change in the cardiac parameters depending on the diabetic metabolic situation over a period of 10 years.2020-08-0