Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Apr 18;17(1):58.
doi: 10.1186/s12933-018-0690-3.

Prevalence of left ventricular systolic dysfunction and heart failure with reduced ejection fraction in men and women with type 2 diabetes mellitus: a systematic review and meta-analysis

Selma Bouthoorn  1 , Aisha Gohar  2   3 , Gideon Valstar  1   4 , Hester M den Ruijter  4 , J B Reitsma  1 , Arno W Hoes  1 , Frans H Rutten  1 ; Queen of Hearts Consortium
Collaborators, Affiliations
Meta-Analysis

Prevalence of left ventricular systolic dysfunction and heart failure with reduced ejection fraction in men and women with type 2 diabetes mellitus: a systematic review and meta-analysis

Selma Bouthoorn et al. Cardiovasc Diabetol. .

Abstract

Background: Type 2 diabetes mellitus (T2D) is associated with the development of left ventricular systolic dysfunction (LVSD) and heart failure with reduced ejection fraction (HFrEF). T2D patients with LVSD are at higher risk of mortality and morbidity than patients without LVSD, while progression of LVSD can be delayed or halted by the use of proven therapies. As estimates of the prevalence are scarce and vary considerably, the aim of this study was to retrieve summary estimates of the prevalence of LVSD/HFrEF in T2D and to see if there were any sex differences.

Methods: A systematic search of Medline and Embase was performed to extract the prevalence of LVSD/HFrEF in T2D (17 studies, mean age 50.1 ± 6.3 to 71.5 ± 7.5), which were pooled using random-effects meta-analysis.

Results: The pooled prevalence of LVSD was higher in hospital populations (13 studies, n = 5835, 18% [95% CI 17-19%]), than in the general population (4 studies, n = 1707, 2% [95% CI 2-3%]). Seven studies in total reported sex-stratified prevalence estimates (men: 7% [95% CI 5-8%] vs. women: 1.3% [95% CI 0.0.2.2%]). The prevalence of HFrEF was available in one general population study (5.8% [95% CI 3.7.6%], men: 6.8% vs. women: 3.0%).

Conclusions: The summary prevalence of LVSD is higher among T2D patients from a hospital setting compared with from the general population, with a higher prevalence in men than in women in both settings. The prevalence of HFrEF among T2D in the population was only assessed in a single study and again was higher among men than women.

Keywords: HFrEF; LVSD; Meta-analysis; Prevalence; Sex; T2D.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart of the process for selection of relevant articles
Fig. 2
Fig. 2
Prevalence of left ventricular systolic dysfunction among 7542 T2D patients in both the general and hospital population. *Study by Boonman et al. is a HF-screening study which was performed in the general population. The corresponding estimate of LVSD is made up from a sample excluding individuals with previously known HF at the start of the study
Fig. 3
Fig. 3
Prevalence of left ventricular systolic dysfunction among 5835 T2D patients in the hospital setting
Fig. 4
Fig. 4
Prevalence of left ventricular systolic dysfunction among 1707 T2D patients in the general population setting. *Study by Boonman et al. is a HF-screening study which was performed in the general population. The corresponding estimate of LVSD is made up from a sample excluding individuals with previously known HF at the start of the study
Fig. 5
Fig. 5
Prevalence of left ventricular systolic dysfunction among a 1515 male T2D patients and b 1032 female T2D patients in both the general and hospital population. *Study by Boonman et al. is a HF-screening study which was performed in the general population. The corresponding estimate of LVSD is made up from a sample excluding individuals with previously known HF at the start of the study
See this image and copyright information in PMC

References

    1. MacDonald MR, Petrie MC, Varyani F, et al. Impact of diabetes on outcomes in patients with low and preserved ejection fraction heart failure: an analysis of the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) programme. Eur Heart J. 2008;29(11):1377–1385. doi: 10.1093/eurheartj/ehn153. - DOI - PubMed
    1. Boonman-De Winter LJM, Rutten FH, Cramer MJM, et al. High prevalence of previously unknown heart failure and left ventricular dysfunction in patients with type 2 diabetes. Diabetologia. 2012;55(8):2154–2162. doi: 10.1007/s00125-012-2579-0. - DOI - PMC - PubMed
    1. Chaowalit N, Arruda AL, McCully RB, Bailey KR, Pellikka PA. Dobutamine stress echocardiography in patients with diabetes mellitus: enhanced prognostic prediction using a simple risk score. J Am Coll Cardiol. 2006;47(5):1029–1036. doi: 10.1016/j.jacc.2005.10.048. - DOI - PubMed
    1. Van Riet EES, Hoes AW, Limburg A, Landman MAJ, Van Der Hoeven H, Rutten FH. Prevalence of unrecognized heart failure in older persons with shortness of breath on exertion. Eur J Heart Fail. 2014;16(7):772–777. doi: 10.1002/ejhf.110. - DOI - PubMed
    1. Bhatia R, Tu J, Lee D, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355:260–269. doi: 10.1056/NEJMoa051530. - DOI - PubMed

Publication types

MeSH terms