A Study on Heart Failure with Preserved Ejection Fraction among Patients of Type 2 Diabetes Mellitus in a Tertiary Care Hospital, India

Abstract

Introduction: Diabetes is associated with several diabetic-related abnormalities and increased retention of sodium (up regulation of sodium-glucose co transporters) which increases the risk of onset or worsening of heart failure. With this background, the current study was planned to study the prevalence of type 2 diabetes mellitus among patients presenting with heart failure with preserved ejection fraction. Materials and Methods: It was a prospective observational study among patients visiting outpatient department and IPD of Nil Ratan Sircar Medical College & Hospital, India from October 2016 to September 2017. The study was pre-approved by Institutional Ethics Committee and the study was conducted after obtaining permission accordingly. Sample size was 100 patients between 30 and 90 years both male and female. The patients who satisfied inclusion and exclusion criteria have been identified and included in this study. Quantitative data thus obtained have been analyzed and exported to statistical software SPSS ver. 20.0. The continuous variables have been presented as mean ± standard deviation. Results: A total of 100 patients between 30 and 90 years, both male and female who met the inclusion criteria were selected for the study. Majority belonged to the age group of 61–70 years with mean age 63.5 ±7.2 years. 53 were men and 47 were female. Diabetes was present in 51 patients. Majority had ejection fraction between 55 and 60% and mean was 57.3± 6.7%; mostly with normal or near normal systolic function. The elevated mean LVMI indicated LV hypertrophy and decreased mean E/A indicated LV diastolic dysfunction, often produced by diabetes. Mean E/E’ was 9.2 ± 5.4. Grade-2 (DD2) diastolic dysfunction patients were maximum in number comprising 47% followed by Grade-1 (DD1) diastolic dysfunction among 44%, and only 9% had Grade-3 (DD3) diastolic dysfunction. Conclusion: Etiology and treatment approach of HFpEF differs from that of HFrEF. Moreover, diabetes mellitus is the modern day epidemics. Hence, if further studied by multicenter, prospective, longitudinal studies, this association may be used to identify the population at risk.