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Diabetes is the strongest predictor of limited exercise capacity in patients with chronic heart failure

Session Poster Session 3

Speaker Gani Bajraktari

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : G Bajraktari (Pristina,XK), V Berisha-Muharremi (Pristina,XK), E Haliti (Pristina,XK), I Bytyci (Pristina,XK), A Poniku (Pristina,XK), A Ahmeti (Pristina,XK), A Batalli (Pristina,XK), P Ibrahimi (Pristina,XK), R Tafarshiku (Pristina,XK), Z Rexhaj (Pristina,XK), S Elezi (Pristina,XK)

Authors:
G Bajraktari1 , V Berisha-Muharremi1 , E Haliti1 , I Bytyci1 , A Poniku1 , A Ahmeti1 , A Batalli1 , P Ibrahimi1 , R Tafarshiku1 , Z Rexhaj1 , S Elezi1 , 1University Clinical Centre of Kosova (UCC), Service of Cardiology - Pristina - Kosovo Republic of ,

Citation:

Background and Aim: Heart failure is a common cardiovascular complication of diabetes mellitus (DM) and these two diseases often co-exist. The aim of this study was to prospectively examine the relationship between diabetes and functional exercise capacity assessed by by 6 min walk test (6-MWT) in patients with chronic HF.

Methods: In 344 included chronic HF patients (mean age 61 ± 10 years, 54% female), clinical, biochemical and antropometric data were registered. In all study patients an echo-Doppler study and a six-minute walk test (6-MWT) were performed in the same day. Patients were divided into two groups based on the 6-MWT distance (Group I: = 300 m and Group II: >300 m).Based on the left ventricular (LV) ejection fraction (EF), patients were divided into three groups (patients with HF and preserved EF [HFpEF], patients with HF and reduced EF [HFrEF] and patients with HF and mid-range EF [HFmrEF]).

Results: Among 344 HF patients 111 (32%) had DM. Group I were older (p = 0.019), had higher prevalence of diabetes (p < 0.001) and atrial fibrillation (p = 0.001), larger left atrium - LA (p = 0.018), lower hemoglobin level (p = 0.028), lower septal mitral annular plane systolic excursion – MAPSE (p=0.001) and lower tricuspid annular plane systolic excursion - TAPSE (p = 0.027), compared with Group II.

In multivariate analysis, only age of patients [1.031 (1.001-1.061), p=0.042], presence of atrial fibrillation [2.377 (1.020 - 5.539), p=0.045] and diabetes [3.743 (1.988 – 7.048), p<0.001] independently predicted poor 6-MWT performance in HF patients.

Conclusion: Diabetes mellitus is the independent and strongest predictor of limited exercise capacity in chronic HF patients, irrespective of LV ejection fraction. This finding highlights the need for better optimization of medical therapy and regular exercise in diabetic patients with chronic HF.

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