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
Review
. 2019 Oct 15;1(1):25-41.
doi: 10.36628/ijhf.2019.0004. eCollection 2019 Oct.

Common Co-Morbidities in Heart Failure - Diabetes, Functional Mitral Regurgitation and Sleep Apnoea

Andrew J Stewart Coats  1
Affiliations
Review

Common Co-Morbidities in Heart Failure - Diabetes, Functional Mitral Regurgitation and Sleep Apnoea

Andrew J Stewart Coats. Int J Heart Fail. .

Abstract

Heart failure (HF) is a condition that carries a considerable burden of disability many now related to co-existing co-morbidities. The drive to find newer effective therapies targeting novel mechanisms has led to a recent emphasis on treating common co-morbidities that are clustered around contemporary HF patients. Here is renewed contemporary co-morbidities that until recently have received little attention but which are now subject of considerable interest and potential therapeutic advance. These include, diabetes, functional mitral regurgitation and sleep disordered breathing. These three contemporary co-morbidities that have recently been subject to major trial evaluation will be reviewed in this paper.

Keywords: Comorbidity; Diabetes mellitus; Heart failure; Mitral regurgitation; Sleep-disordered breathing.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: Professor Coats declares having received honoraria and/or lecture fees from: Astra Zeneca, Menarini, Novartis, Nutricia, Servier, Vifor, Actimed, CVRx, Enopace, Faraday, Gore, Respicardia, Stealth Peptides, and V-Wave.

Figures

Figure 1
Figure 1. Diabetes related Mechanism for the development of heart failure.
Reproduced with permission from Rosano and Seferovic. AGE = advanced glycation end-product; DBP = diastolic blood pressure; PKC = protein kinase C; RAAS = renin-angiotensin-aldosterone system; SBP = systolic blood pressure.
Figure 2
Figure 2. A pictorial representation of functional MR in HFrEF (left panel) and the deposition of a Mitraclip device (right panel).
Reproduced with permission from Brown and Lim. “Catheter Management Of Mitral Regurgitation.” SourceStatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536988/figure/article-179.image.f1/. MR = mitral regurgitation; HFrEF = heart failure with reduced ejection fraction.
Figure 3
Figure 3. CSA with cheyne-stokes breathing.
Selected channels of a polysomnogram of a patient with CSA with Cheyne-Stokes breathing. Reproduced from Bradley et al. CSA = central sleep apnea.
See this image and copyright information in PMC

References

    1. Authors/Task Force Members. Rydén L, Grant PJ, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD) Eur Heart J. 2013;34:3035–3087. - PubMed
    1. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–412. - PMC - PubMed
    1. Metra M, Zacà V, Parati G, et al. Cardiovascular and noncardiovascular comorbidities in patients with chronic heart failure. J Cardiovasc Med (Hagerstown) 2011;12:76–84. - PubMed
    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;29:1377–1385. - PubMed
    1. Fadini GP, Avogaro A, Degli Esposti L, et al. Risk of hospitalization for heart failure in patients with type 2 diabetes newly treated with DPP-4 inhibitors or other oral glucose-lowering medications: a retrospective registry study on 127,555 patients from the Nationwide OsMed Health-DB Database. Eur Heart J. 2015;36:2454–2462. - PubMed