Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study
BackgroundA substantial portion of heart failure (HF) patients adherent to guideline-directed medical therapies have experienced improved ejection fraction (EF), termed HFimpEF. Glycemic variability (GV) has emerged as a critical cardiometabolic factor. However, the relation between long-term GV and...
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| Format: | Article |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1211954/full |
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| author | Chen Die Yang Jia Wei Chen Jin Wei Quan Xin Yi Shu Shuo Feng Muladili Aihemaiti Feng Hua Ding Wei Feng Shen Wei Feng Shen Lin Lu Lin Lu Rui Yan Zhang Xiao Qun Wang Xiao Qun Wang |
| author_facet | Chen Die Yang Jia Wei Chen Jin Wei Quan Xin Yi Shu Shuo Feng Muladili Aihemaiti Feng Hua Ding Wei Feng Shen Wei Feng Shen Lin Lu Lin Lu Rui Yan Zhang Xiao Qun Wang Xiao Qun Wang |
| author_sort | Chen Die Yang |
| collection | DOAJ |
| description | BackgroundA substantial portion of heart failure (HF) patients adherent to guideline-directed medical therapies have experienced improved ejection fraction (EF), termed HFimpEF. Glycemic variability (GV) has emerged as a critical cardiometabolic factor. However, the relation between long-term GV and the incidence of HFimpEF is still unclear.MethodsA total of 591 hospitalized HF patients with reduced EF (HFrEF, EF≤ 40%) admitted from January 2013 to December 2020 were consecutively enrolled. Repeat echocardiograms were performed at baseline and after around 12 months. The incidence of HFimpEF, defined as (1) an absolute EF improvement ≥10% and (2) a second EF > 40% and its association with long-term fasting plasma glucose (FPG) variability were analyzed.ResultsDuring a mean follow-up of 12.2 ± 0.6 months, 218 (42.0%) patients developed HFimpEF. Multivariate analysis showed FPG variability was independently associated with the incidence of HFimpEF after adjustment for baseline HbA1c, mean FPG during follow-up and other traditional risk factors (odds ratio [OR] for highest vs. lowest quartile of CV of FPG: 0.487 [95% CI 0.257~0.910]). Evaluation of GV by alternative measures yielded similar results. Subgroup analysis revealed that long-term GV was associated with HFimpEF irrespective of glycemic levels and diabetic conditions.ConclusionsThis study reveals that greater FPG variability is associated with compromised development of HFimpEF. A more stable control of glycemic levels might provide favorable effects on myocardial functional recovery in HF patients even without diabetes. |
| first_indexed | 2024-03-11T23:12:25Z |
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| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T23:12:25Z |
| publishDate | 2023-09-01 |
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| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-604a509c4ba64226b0d775dc2d1241ba2023-09-21T07:20:18ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-09-011410.3389/fendo.2023.12119541211954Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort studyChen Die Yang0Jia Wei Chen1Jin Wei Quan2Xin Yi Shu3Shuo Feng4Muladili Aihemaiti5Feng Hua Ding6Wei Feng Shen7Wei Feng Shen8Lin Lu9Lin Lu10Rui Yan Zhang11Xiao Qun Wang12Xiao Qun Wang13Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaInstitute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, ChinaBackgroundA substantial portion of heart failure (HF) patients adherent to guideline-directed medical therapies have experienced improved ejection fraction (EF), termed HFimpEF. Glycemic variability (GV) has emerged as a critical cardiometabolic factor. However, the relation between long-term GV and the incidence of HFimpEF is still unclear.MethodsA total of 591 hospitalized HF patients with reduced EF (HFrEF, EF≤ 40%) admitted from January 2013 to December 2020 were consecutively enrolled. Repeat echocardiograms were performed at baseline and after around 12 months. The incidence of HFimpEF, defined as (1) an absolute EF improvement ≥10% and (2) a second EF > 40% and its association with long-term fasting plasma glucose (FPG) variability were analyzed.ResultsDuring a mean follow-up of 12.2 ± 0.6 months, 218 (42.0%) patients developed HFimpEF. Multivariate analysis showed FPG variability was independently associated with the incidence of HFimpEF after adjustment for baseline HbA1c, mean FPG during follow-up and other traditional risk factors (odds ratio [OR] for highest vs. lowest quartile of CV of FPG: 0.487 [95% CI 0.257~0.910]). Evaluation of GV by alternative measures yielded similar results. Subgroup analysis revealed that long-term GV was associated with HFimpEF irrespective of glycemic levels and diabetic conditions.ConclusionsThis study reveals that greater FPG variability is associated with compromised development of HFimpEF. A more stable control of glycemic levels might provide favorable effects on myocardial functional recovery in HF patients even without diabetes.https://www.frontiersin.org/articles/10.3389/fendo.2023.1211954/fullglycemic variabilityheart failure with improved ejection fractionheart failure with reduced ejection fractionmyocardial recoveryfasting plasma glucose |
| spellingShingle | Chen Die Yang Jia Wei Chen Jin Wei Quan Xin Yi Shu Shuo Feng Muladili Aihemaiti Feng Hua Ding Wei Feng Shen Wei Feng Shen Lin Lu Lin Lu Rui Yan Zhang Xiao Qun Wang Xiao Qun Wang Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study Frontiers in Endocrinology glycemic variability heart failure with improved ejection fraction heart failure with reduced ejection fraction myocardial recovery fasting plasma glucose |
| title | Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study |
| title_full | Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study |
| title_fullStr | Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study |
| title_full_unstemmed | Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study |
| title_short | Long-term glycemic variability predicts compromised development of heart failure with improved ejection fraction: a cohort study |
| title_sort | long term glycemic variability predicts compromised development of heart failure with improved ejection fraction a cohort study |
| topic | glycemic variability heart failure with improved ejection fraction heart failure with reduced ejection fraction myocardial recovery fasting plasma glucose |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1211954/full |
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