Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure

Abstract We aimed to investigate the sex differences in associations of diabetes mellitus (DM) with echocardiographic phenotypes and clinical outcomes of heart failure (HF). We studied 4,180 patients admitted for acute HF between 2009 and 2016 (median follow-up, 31.7 months) whose left ventricular g...

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Autores principales:	Soongu Kwak, In-Chang Hwang, Jin Joo Park, Jae-Hyeong Park, Jun-Bean Park, Goo-Yeong Cho
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/95e9baf8ab09446da288cc370669a95f
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spelling	oai:doaj.org-article:95e9baf8ab09446da288cc370669a95f2021-12-02T18:24:54ZSex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure10.1038/s41598-021-91170-x2045-2322https://doaj.org/article/95e9baf8ab09446da288cc370669a95f2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91170-xhttps://doaj.org/toc/2045-2322Abstract We aimed to investigate the sex differences in associations of diabetes mellitus (DM) with echocardiographic phenotypes and clinical outcomes of heart failure (HF). We studied 4,180 patients admitted for acute HF between 2009 and 2016 (median follow-up, 31.7 months) whose left ventricular global longitudinal strain (LV-GLS) data were available. Patients were compared by sex and DM. Structural equation model (SEM) analysis was performed to evaluate the moderating effects of two causal paths, via ischemic heart disease (IHD) and LV-GLS, linking DM with mortality. Compared to non-diabetic women, diabetic women had significantly lower LV-GLS (11.3% versus 10.1%, p < 0.001), but the difference was attenuated within men (9.7% versus 9.2%, p = 0.014) (p-for-interaction by sex = 0.018). In Cox analyses, DM was an independent predictor for higher mortality in both sexes (women: adjusted hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.15–1.59 versus men: HR 1.24, 95% CI 1.07–1.44, p-for-interaction by sex = 0.699). Restricted cubic spline curves showed that LV-GLS consistently declined, and mortality increased in women with worsening hyperglycemia, but these trends were not evident in men. In SEM analysis, the main driver from DM to mortality differed by sex; men had a stronger effect via IHD than LV-GLS, whereas LV-GLS was the only predominant path in women.Soongu KwakIn-Chang HwangJin Joo ParkJae-Hyeong ParkJun-Bean ParkGoo-Yeong ChoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Soongu Kwak In-Chang Hwang Jin Joo Park Jae-Hyeong Park Jun-Bean Park Goo-Yeong Cho Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
description	Abstract We aimed to investigate the sex differences in associations of diabetes mellitus (DM) with echocardiographic phenotypes and clinical outcomes of heart failure (HF). We studied 4,180 patients admitted for acute HF between 2009 and 2016 (median follow-up, 31.7 months) whose left ventricular global longitudinal strain (LV-GLS) data were available. Patients were compared by sex and DM. Structural equation model (SEM) analysis was performed to evaluate the moderating effects of two causal paths, via ischemic heart disease (IHD) and LV-GLS, linking DM with mortality. Compared to non-diabetic women, diabetic women had significantly lower LV-GLS (11.3% versus 10.1%, p < 0.001), but the difference was attenuated within men (9.7% versus 9.2%, p = 0.014) (p-for-interaction by sex = 0.018). In Cox analyses, DM was an independent predictor for higher mortality in both sexes (women: adjusted hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.15–1.59 versus men: HR 1.24, 95% CI 1.07–1.44, p-for-interaction by sex = 0.699). Restricted cubic spline curves showed that LV-GLS consistently declined, and mortality increased in women with worsening hyperglycemia, but these trends were not evident in men. In SEM analysis, the main driver from DM to mortality differed by sex; men had a stronger effect via IHD than LV-GLS, whereas LV-GLS was the only predominant path in women.
format	article
author	Soongu Kwak In-Chang Hwang Jin Joo Park Jae-Hyeong Park Jun-Bean Park Goo-Yeong Cho
author_facet	Soongu Kwak In-Chang Hwang Jin Joo Park Jae-Hyeong Park Jun-Bean Park Goo-Yeong Cho
author_sort	Soongu Kwak
title	Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
title_short	Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
title_full	Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
title_fullStr	Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
title_full_unstemmed	Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
title_sort	sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/95e9baf8ab09446da288cc370669a95f
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Sex-specific impact of diabetes mellitus on left ventricular systolic function and prognosis in heart failure

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