Heart failure phenotypes and clinical and laboratory features of patients with type 2 diabetes in inpatient endocrinology and cardiology practice

Abstract

Introduction. Type 2 diabetes is a generally recognized risk factor for the development of not only ASCVD, microvascular complications, but also CHF.Aim. To evaluate the prevalence of CHF phenotypes and clinical and laboratory characteristics of patients with type 2 diabetes who are hospitalized in the endocrinology and cardiology departments.Materials and methods. A total of 107 patients with T2DM was included in the analysis. All patients were examined in accordance with the standards and procedures for providing medical care, followed by evaluation of clinical, laboratory and instrumental indicators.Results. The average age of these patients was 69.7 ± 9.12 years, the age of onset of type 2 diabetes was 58.9 ± 10 years, the duration of diabetes was 6.5 [4; 17] years. When analyzing the main metabolic parameters, the average HbA1c was 8.18 ± 1.72%, BMI 32 [29; 38] kg/m2. The predominant number of patients with type 2 diabetes had a CHF phenotype with preserved ejection fraction, the proportion of which was 68.22%, 19.63% had HF with mildly reduced ejection fraction and 12.15% – heart failure with reduced ejection fraction (HFrEF).Conclusions. The population of patients with type 2 diabetes and CHF, regardless of the specialty of the department, was characterized by a lack of targeted compensation for type 2 diabetes, IR, obesity and a high prevalence of hypertension and dyslipidemia. In the endocrinology department, patients significantly more often had a restrictive phenotype of HF and was characterized by a moderate increase in NTproBNP, with a reduced eGFR, were female, of an older age category, with longer duration of diabetes and higher HbA1c levels. All this dictates the high need for integrating SGLT2 inhibitors into patient management regimens. In the cardiology department, a high frequency of the dilated phenotype of CHF with low EF and ischemic heart disease was observed against the background of significantly increased NTproBNP values, significantly more often in males, middle age, with a short duration of diabetes. According to the standards of medical care, such patients require quadruple therapy, one of the mandatory components of which will be iSGLT 2 type.