Abstract
Heart failure (HF) has been a hot topic in diabetology in the last few years, mainly due to the central role of sodium-glucose cotransporter 2 inhibitors (iSGLT2) in the prevention and treatment of cardiovascular disease and heart failure. It is well known that HF is a common complication in diabetes. However, most of the knowledge about it and the evidence of cardiovascular safety trials with antidiabetic drugs refer to type 2 diabetes (T2D). The epidemiology, etiology, and pathophysiology of HF in type 1 diabetes (T1D) is still not well studied, though there are emerging data about it since life expectancy for T1D has increased in the last decades and there are more elderly patients with T1D. The association of T1D and HF confers a worse prognosis than in T2D, thus it is important to investigate the characteristics, risk factors, and pathophysiology of this disease in order to effectively design prevention strategies and therapeutic tools.
Highlights
Heart failure (HF) is one of the most frequent causes of hospital admission and has a poor prognosis in most cases, despite great pharmacological advances developed in recent decades for heart failure with reduced ejection fraction (HFrEF; left ventricular ejection fraction < 40%) [1]
The pathophysiological timeline of diabetic cardiomyopathy seems to follow the trend observed in other non-structural heart diseases, with the initial development of left ventricular diastolic dysfunction followed by subclinical systolic dysfunction with preserved ejection fraction and progressing to HFrEF [44,45]
In the LIVE study (n = 241), it was found that the use of liraglutide did not affect left ventricular systolic function (LVEF) compared to the placebo in patients with stable HF, it was associated with an increase in heart rate and serious adverse cardiac events, such as sustained ventricular tachycardia, atrial fibrillation, or worsening ischemic heart disease (10% vs 3%, p = 0.04)
Summary
Ana María Gómez-Perez 1,2,3 , Miguel Damas-Fuentes 1,2 , Isabel Cornejo-Pareja 1,2,3, *. Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
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