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Contribution of type 2 diabetes mellitus in deteriorate 24 hours ABPM vascular risk profile and ventricular function in patients with acute heart failure

Session Poster Session 1

Speaker Ana Gonzalez

Congress : Acute Cardiovascular Care 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure - Clinical
  • Session type : Poster Session
  • FP Number : P124

Authors : AM Gonzalez (Malaga,ES), AM Garcia-Bellon (Malaga,ES), C Jimenez Rubio (Velez-Malaga,ES), M De Mora-Martin (Malaga,ES)

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Authors:
AM Gonzalez1 , AM Garcia-Bellon1 , C Jimenez Rubio2 , M De Mora-Martin1 , 1Regional University Hospital Carlos Haya, Clinical Management Unit (U.G.C.) Heart - Malaga - Spain , 2Axarquia Hospital, Cardiology Department - Velez-Malaga - Spain ,

Citation:

Purpose:
Our aim was  to evaluate a possible negative influence of the presence of  Type 2 Diabetes mellitus (T2DM) on 24 h. ambulatory blood pressure monitoring (ABPM) pattern, vascular risk profile and severity of  left ventricular (LV) function in patients with Acute Heart Failure (AHF).

Methods:  In 184 patients with AHF we compare clinical features of 64 (65±9 years / 87,5% males) with T2DM versus 120 (63±11 years / 68,3% males) non-T2DM.

In addition to clinical examination and analytical parameters, all patients underwent  a 24 h, ABPM and echocardiogram and evaluation of degree of severity LV Dysfunction.

Results:
Patients with T2DM had higher (p <0.001) prevalence (%) of Hypertension (75 vs 46.7), dyslipidemia (65.6 vs 28.3), obesity (47 vs 43), and worse renal function (fGe: 64.7 vs 72.3 ml/min/1.75m2). Etiology IC: Hypertensive and/or ischemic heart disease: 75% vs 60%. Mean Values  of 24 h ABPM measurements are in table 1.

No significant differences in diastolic blood presure (DBP) between groups, but patient with T2DM present higher average values (p <0.05) of SBP 24h (mmHg): 116/111); daytime (117/112) and nightime (114/108); higher 24 h Pulse Pressure (50 vs 46mmHg) and non-dipper pattern frequency (84.7 vs 79.35), as well as a greater proportion of patients with moderate/severe LV dysfunction (87.6 vs 81.7%) (p <0 , 05).

We also observed worse NYHA functional class in T2DM patients: NYHA II-III 84,4 vs 58,3%, p< 0,001.

Conclusions:
In patients with AHF, the presence of T2DM  contributes to show greater hypertensive and/or ischaemic ethiology, further deterioration of 24 h ABPM pattern and worse left ventricular myocardial function.

T2DM can be considered as a risk factor and worsening of heart failure. 24h ABPM may contibute to a better prognostic evaluation in these patients.

Mean Values

(mmHg)

T2DM p NonT2DM
24 SBP 116 ± 16 <0.05 111±15
Daytime SBP 117 ± 15 <0.05 112±15
Nightime SBP 114 ± 18 <0.04 108±16
24h DBP 65 ± 7 ns 65±8
Daytime DBP 67 ± 8 ns 67±9
Nightime DBP 64 ± 7 ns 69±9
Pulse Pressure 50 ± 13 0.05 46±11
Nocturnal PP 51 ± 15 0.05 47±12
SBP: Systolic blood pressure DBP: Diastolic blood pressure PP: Pulse pressure


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