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Review
. 2023 Mar 13;15(6):1384.
doi: 10.3390/nu15061384.

Cardiometabolic Care: Assessing Patients with Diabetes Mellitus with No Overt Cardiovascular Disease in the Light of Heart Failure Development Risk

Christina Chrysohoou  1 , Christos Fragoulis  1 , Ioannis Leontsinis  1 , Ioannis Gastouniotis  1 , Dimitra Fragouli  1 , Maximos Georgopoulos  1 , Emmanouil Mantzouranis  1 , Marina Noutsou  2 , Konstantinos P Tsioufis  1
Affiliations
Review

Cardiometabolic Care: Assessing Patients with Diabetes Mellitus with No Overt Cardiovascular Disease in the Light of Heart Failure Development Risk

Christina Chrysohoou et al. Nutrients. .

Abstract

The mechanisms leading to the development of heart failure (HF) in diabetes mellitus (DM) patients are multifactorial. Assessing the risk of HF development in patients with DM is valuable not only for the identification of a high-risk subgroup, but also equally important for defining low-risk subpopulations. Nowadays, DM and HF have been recognized as sharing similar metabolic pathways. Moreover, the clinical manifestation of HF can be independent of LVEF classification. Consequently, approaching HF should be through structural, hemodynamic and functional evaluation. Thus, both imaging parameters and biomarkers are important tools for the recognition of diabetic patients at risk of HF manifestation and HF phenotypes, and arrhythmogenic risk, and eventually for prognosis, aiming to improve patients' outcomes utilizing drugs and non-pharmaceutical cardioprotective tools such as diet modification.

Keywords: biomarkers; diabetes mellitus; heart failure; risk.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Multifactorial pathogenesis of heart failure in patients with T2DM. AGEs: Advanced glycation end products, EAT: epicardial adipose tissue, NO: nitric oxide, ROS: reactive oxygen species.
Figure 2
Figure 2
Prognostication of heart failure in patients with T2DM. CMR: cardiac magnetic resonance, CPET: cardiopulmonary exercise test, ECHO: echocardiogram, HF: heart failure, Med: Mediterranean, NPs: natriuretic peptides, T2DM: type 2 diabetes mellitus. The diagram presents a proposed evaluation of T2DM patients for risk stratification of heart failure, involving cardiac imaging, functional capacity, the Mediterranean diet score and biomarkers.
See this image and copyright information in PMC

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