Type 2 diabetes mellitus(T2DM or T2D)is a devastating metabolic abnormality featured by insulin resistance,hyperglycemia,and hyperlipidemia.T2D provokes unique metabolic changes and compromises cardiovascular geometry...Type 2 diabetes mellitus(T2DM or T2D)is a devastating metabolic abnormality featured by insulin resistance,hyperglycemia,and hyperlipidemia.T2D provokes unique metabolic changes and compromises cardiovascular geometry and function.Meanwhile,T2D increases the overall risk for heart failure(HF)and acts independent of classical risk factors including coronary artery disease,hypertension,and valvular heart diseases.The incidence of HF is extremely high in patients with T2D and is manifested as HF with preserved,reduced,and midrange ejection fraction(HFpEF,HFrEF,and HFmrEF,respectively),all of which significantly worsen the prognosis for T2D.HFpEFis seen in approximately half of the HF cases and is defined as a heterogenous syndrome with discrete phenotypes,particularly in close association with metabolic syndrome.Nonetheless,management of HFpEF in T2D remains unclear,largely due to the poorly defined pathophysiology behind HFpEF.Here,in this review,we will summarize findings from multiple preclinical and clinical studies as well as recent clinical trials,mainly focusing on the pathophysiology,potential mechanisms,and therapies of HFpEF in T2D.展开更多
Heart failure(HF)is a worldwide problem due to the substantial morbidity and mortality of patients with cardiovascular diseases.Recently,the PARADIGM-HF trial(the Prospective comparison of angiotensin receptor-neprily...Heart failure(HF)is a worldwide problem due to the substantial morbidity and mortality of patients with cardiovascular diseases.Recently,the PARADIGM-HF trial(the Prospective comparison of angiotensin receptor-neprilysin inhibitor[ARNI]with angiotensin-converting enzyme inhibitor[ACEI]to Determine Impact on Global Mortality and morbidity in Heart Failure trial)showed that ischemic heart disease is the most common etiology of HF,which accounts for 60%of HF with reduced ejection fraction(HFrEF).展开更多
基金This work was supported by grants from the National Natural Science Foundation of China(81770261 and 82130011)Science and Technology Innovation Project of the Chinese Academy of Medical Sciences(Health and Longevity Pilot Special Project 2019-RC-HL-021).
文摘Type 2 diabetes mellitus(T2DM or T2D)is a devastating metabolic abnormality featured by insulin resistance,hyperglycemia,and hyperlipidemia.T2D provokes unique metabolic changes and compromises cardiovascular geometry and function.Meanwhile,T2D increases the overall risk for heart failure(HF)and acts independent of classical risk factors including coronary artery disease,hypertension,and valvular heart diseases.The incidence of HF is extremely high in patients with T2D and is manifested as HF with preserved,reduced,and midrange ejection fraction(HFpEF,HFrEF,and HFmrEF,respectively),all of which significantly worsen the prognosis for T2D.HFpEFis seen in approximately half of the HF cases and is defined as a heterogenous syndrome with discrete phenotypes,particularly in close association with metabolic syndrome.Nonetheless,management of HFpEF in T2D remains unclear,largely due to the poorly defined pathophysiology behind HFpEF.Here,in this review,we will summarize findings from multiple preclinical and clinical studies as well as recent clinical trials,mainly focusing on the pathophysiology,potential mechanisms,and therapies of HFpEF in T2D.
基金This study was supported by grants from the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20161402)the Science and Technology Commission of Shanghai Municipality(No.15DZ1942003)。
文摘Heart failure(HF)is a worldwide problem due to the substantial morbidity and mortality of patients with cardiovascular diseases.Recently,the PARADIGM-HF trial(the Prospective comparison of angiotensin receptor-neprilysin inhibitor[ARNI]with angiotensin-converting enzyme inhibitor[ACEI]to Determine Impact on Global Mortality and morbidity in Heart Failure trial)showed that ischemic heart disease is the most common etiology of HF,which accounts for 60%of HF with reduced ejection fraction(HFrEF).
