Heart failure and diabetes mellitus: insight into comorbidity
https://doi.org/10.14341/DM9784
Abstract
Diabetes mellitus (DM) and heart failure (HF) are frequent comorbidities with a bidirectional relationship. Patients with HF have increased risk of developing DM, and those with DM are at greater risk of developing HF. HF does not fit clearly into the microangiopathy and macroangiopathy groups. It is known that coronary artery disease and arterial hypertension are the major causes of HF; however, it has been shown that DM can trigger functional and structural abnormalities in the myocardium via diabetic cardiomyopathy, a condition with either restrictive or dilated phenotype. While HF treatment is equally effective and safe in patients with and without DM, this statement is not applicable for antidiabetic treatment. Several antidiabetic drugs, such as rosiglitazone, pioglitazone and saxagliptin increase the risk of hospitalisation for HF, therefore these antidiabetic drugs are contraindicated in patients with DM and HF or patients at risk of developing HF. Despite a large number of clinical evidence, uncertainty about the safety of antidiabetic drugs in patients with HF always exists. In this review, the issues of DM treatment in patients with HF are addressed in detail.
About the Authors
Nina A. PetuninaI.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD, Professor
Ivan V. Trukhin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Liubov V. Trukhina
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD
Zhanna M. Sizova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD, Professor
Valeria L. Zakharova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD, professor assistant
References
1. Suskin N, McKelvie RS, Burns RJ, et al. Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure. Eur Heart J. 2000;21(16):1368-1375. doi: 10.1053/euhj.1999.2043
2. McMurray JJV, Gerstein HC, Holman RR, Pfeffer MA. Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored. Lancet Diabetes Endocrinol. 2014;2(10):843-851. doi: 10.1016/s2213-8587(14)70031-2
3. Bell DSH. Heart Failure: The frequent, forgotten, and often fatal complication of diabetes. Diabetes Care. 2003;26(8):2433-2441. doi: 10.2337/diacare.26.8.2433
4. Дедов И.И., Шестакова М.В., Майоров А.Ю., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. / Под ред. Дедова И.И., Шестаковой М.В., Майорова А.Ю. – 8-й выпуск // Сахарный диабет. — 2017. — Т. 20. — №1S. — C. 1-121. [Dedov II, Shestakova MV, Mayorov AY, et al. Dedov II, Shestakova MV, Mayorov AY, editors. Standards of specialized diabetes care. Edited by. 8th ed. Diabetes mellitus. 2017;20(1S):1-121. (In Russ.)] doi: 10.14341/DM20171S8
5. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-2200. doi: 10.1093/eurheartj/ehw128
6. van Riet EE, Hoes AW, Wagenaar KP, et al. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18(3):242-252. doi: 10.1002/ejhf.483
7. Davies MK, Hobbs FDR, Davis RC, et al. Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: a population based study. The Lancet. 2001;358(9280):439-444. doi: 10.1016/s0140-6736(01)05620-3
8. Seferovic PM, Petrie MC, Filippatos GS, et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(5):853-872. doi: 10.1002/ejhf.1170
9. Thrainsdottir IS, Aspelund T, Thorgeirsson G, et al. The Association Between Glucose Abnormalities and Heart Failure in the Population-Based Reykjavik Study. Diabetes Care. 2005;28(3):612-616. doi: 10.2337/diacare.28.3.612
10. Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: The Framingham study. The Am J Cardiol. 1974;34(1):29-34. doi: 10.1016/0002-9149(74)90089-7
11. Nichols GA, Gullion CM, Koro CE, et al. The Incidence of Congestive Heart Failure in Type 2 Diabetes: An update. Diabetes Care. 2004;27(8):1879-1884. doi: 10.2337/diacare.27.8.1879
12. Shah AD, Langenberg C, Rapsomaniki E, et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1·9 million people. Lancet Diabetes Endocrinol. 2015;3(2):105-113. doi: 10.1016/s2213-8587(14)70219-0
13. Nichols GA, Hillier TA, Erbey JR, Brown JB. Congestive Heart Failure in Type 2 Diabetes: Prevalence, incidence, and risk factors. Diabetes Care. 2001;24(9):1614-1619. doi: 10.2337/diacare.24.9.1614
14. Boonman-de Winter LJ, Rutten FH, Cramer MJ, et al. High prevalence of previously unknown heart failure and left ventricular dysfunction in patients with type 2 diabetes. Diabetologia. 2012;55(8):2154-2162. doi: 10.1007/s00125-012-2579-0
15. Chou E, Suzuma I, Way KJ, et al. Decreased Cardiac Expression of Vascular Endothelial Growth Factor and Its Receptors in Insulin-Resistant and Diabetic States. Circulation. 2002;105(3):373-379. doi: 10.1161/hc0302.102143
16. Stone PH, Muller JE, Hartwell T, et al. The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: Contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis. J Am Coll Cardiol. 1989;14(1):49-57. doi: 10.1016/0735-1097(89)90053-3
17. Seferovic PM, Paulus WJ. Clinical diabetic cardiomyopathy: a two-faced disease with restrictive and dilated phenotypes. Eur Heart J. 2015;36(27):1718-1727, 1727a-1727c. doi: 10.1093/eurheartj/ehv134
18. Lundbæk K. Diabetic Angiopathy. Lancet. 1954;263(6808):377-379. doi: 10.1016/s0140-6736(54)90924-1
19. Rubler S, Dlugash J, Yuceoglu YZ, et al. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am J Cardiol. 1972;30(6):595-602. doi: 10.1016/0002-9149(72)90595-4
20. Aneja A, Tang WH, Bansilal S, et al. Diabetic cardiomyopathy: insights into pathogenesis, diagnostic challenges, and therapeutic options. Am J Med. 2008;121(9):748-757. doi: 10.1016/j.amjmed.2008.03.046
21. Bugger H, Abel ED. Molecular mechanisms of diabetic cardiomyopathy. Diabetologia. 2014;57(4):660-671. doi: 10.1007/s00125-014-3171-6
22. Shimizu I, Minamino T, Toko H, et al. Excessive cardiac insulin signaling exacerbates systolic dysfunction induced by pressure overload in rodents. J Clin Invest. 2010;120(5):1506-1514. doi: 10.1172/JCI40096
23. Hamdani N, Bishu KG, von Frieling-Salewsky M, et al. Deranged myofilament phosphorylation and function in experimental heart failure with preserved ejection fraction. Cardiovasc Res. 2013;97(3):464-471. doi: 10.1093/cvr/cvs353
24. Asbun J, Villarreal FJ. The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy. J Am Coll Cardiol. 2006;47(4):693-700. doi: 10.1016/j.jacc.2005.09.050
25. Perin PC, Maule S, Quadri R. Sympathetic Nervous System, Diabetes, and Hypertension. Clin Exp Hypertens. 2001;23(1-2):45-55. doi: 10.1081/ceh-100001196
26. Pop-Busui R, Kirkwood I, Schmid H, et al. Sympathetic dysfunction in type 1 diabetes: association with impaired myocardial blood flow reserve and diastolic dysfunction. J Am Coll Cardiol. 2004;44(12):2368-2374. doi: 10.1016/j.jacc.2004.09.033
27. Gonzalez A, Ravassa S, Beaumont J, et al. New targets to treat the structural remodeling of the myocardium. J Am Coll Cardiol. 2011;58(18):1833-1843. doi: 10.1016/j.jacc.2011.06.058
28. Rijzewijk LJ, van der Meer RW, Lamb HJ, et al. Altered myocardial substrate metabolism and decreased diastolic function in nonischemic human diabetic cardiomyopathy: studies with cardiac positron emission tomography and magnetic resonance imaging. J Am Coll Cardiol. 2009;54(16):1524-1532. doi: 10.1016/j.jacc.2009.04.074
29. Maggioni AP, Anker SD, Dahlstrom U, et al. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2013;15(10):1173-1184. doi: 10.1093/eurjhf/hft134
30. Granger CB, McMurray JJV, Yusuf S, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet. 2003;362(9386):772-776. doi: 10.1016/s0140-6736(03)14284-5
31. Bakris GL, Fonseca V, Katholi RE, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. JAMA. 2004;292(18):2227-2236. doi: 10.1001/jama.292.18.2227
32. Torp-Pedersen C, Metra M, Charlesworth A, et al. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: data from the Carvedilol Or Metoprolol European Trial (COMET). Heart. 2007;93(8):968-973. doi: 10.1136/hrt.2006.092379
33. Deedwania PC, Giles TD, Klibaner M, et al. Efficacy, safety and tolerability of metoprolol CR/XL in patients with diabetes and chronic heart failure: experiences from MERIT-HF. Am Heart J. 2005;149(1):159-167. doi: 10.1016/j.ahj.2004.05.056
34. Dei Cas A, Khan SS, Butler J, et al. Impact of diabetes on epidemiology, treatment, and outcomes of patients with heart failure. JACC Heart Fail. 2015;3(2):136-145. doi: 10.1016/j.jchf.2014.08.004
35. Seferovic JP, Claggett B, Seidelmann SB, et al. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial. Lancet Diabetes Endocrinol. 2017;5(5):333-340. doi: 10.1016/s2213-8587(17)30087-6
36. Scirica BM, Braunwald E, Raz I, et al. Heart failure, saxagliptin, and diabetes mellitus: observations from the SAVOR-TIMI 53 randomized trial. Circulation. 2014;130(18):1579-1588. doi: 10.1161/CIRCULATIONAHA.114.010389
37. Lago RM, Singh PP, Nesto RW. Congestive heart failure and cardiovascular death in patients with prediabetes and type 2 diabetes given thiazolidinediones: a meta-analysis of randomised clinical trials. Lancet. 2007;370(9593):1129-1136. doi: 10.1016/s0140-6736(07)61514-1
38. Saad S, Zhang J, Yong R, et al. Role of the EGF receptor in PPARgamma-mediated sodium and water transport in human proximal tubule cells. Diabetologia. 2013;56(5):1174-1182. doi: 10.1007/s00125-013-2835-y
39. Dormandy JA, Charbonnel B, Eckland DJA, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005;366(9493):1279-1289. doi: 10.1016/s0140-6736(05)67528-9
40. Vaccaro O, Masulli M, Nicolucci A, et al. Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial. Lancet Diabetes Endocrinol. 2017;5(11):887-897. doi: 10.1016/s2213-8587(17)30317-0
41. White WB, Cannon CP, Heller SR, et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med. 2013;369(14):1327-1335. doi: 10.1056/NEJMoa1305889
42. McGuire DK, Van de Werf F, Armstrong PW, et al. Association Between Sitagliptin Use and Heart Failure Hospitalization and Related Outcomes in Type 2 Diabetes Mellitus: Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. 2016;1(2):126-135. doi: 10.1001/jamacardio.2016.0103
43. MacDonald MR, Petrie MC, Hawkins NM, et al. Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J. 2008;29(10):1224-1240. doi: 10.1093/eurheartj/ehn156
44. Gerstein HC, Bosch J, Dagenais GR, et al. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012;367(4):319-328. doi: 10.1056/NEJMoa1203858
45. Marso SP, McGuire DK, Zinman B, et al. Efficacy and Safety of Degludec versus Glargine in Type 2 Diabetes. N Engl J Med. 2017;377(8):723-732. doi: 10.1056/NEJMoa1615692
46. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837-853. doi: 10.1016/s0140-6736(98)07019-6
47. ADVANCE Collaborative Group, Patel A, MacMahon S, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560-2572. doi: 10.1056/NEJMoa0802987
48. Papanas N, Maltezos E, Mikhailidis DP. Metformin and heart failure: never say never again. Expert Opin Pharmacother. 2012;13(1):1-8. doi: 10.1517/14656566.2012.638283
49. MacDonald MR, Eurich DT, Majumdar SR, et al. Treatment of type 2 diabetes and outcomes in patients with heart failure: a nested case-control study from the U.K. General Practice Research Database. Diabetes Care. 2010;33(6):1213-1218. doi: 10.2337/dc09-2227
50. Boussageon R, Supper I, Bejan-Angoulvant T, et al. Reappraisal of metformin efficacy in the treatment of type 2 diabetes: a meta-analysis of randomised controlled trials. PLoS Med. 2012;9(4):e1001204. doi: 10.1371/journal.pmed.1001204
51. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352(9131):854-865. doi: 10.1016/s0140-6736(98)07037-8
52. Evans JM, Doney AS, AlZadjali MA, et al. Effect of Metformin on mortality in patients with heart failure and type 2 diabetes mellitus. Am J Cardiol. 2010;106(7):1006-1010. doi: 10.1016/j.amjcard.2010.05.031
53. Andersson C, Olesen JB, Hansen PR, et al. Metformin treatment is associated with a low risk of mortality in diabetic patients with heart failure: a retrospective nationwide cohort study. Diabetologia. 2010;53(12):2546-2553. doi: 10.1007/s00125-010-1906-6
54. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375(4):311-322. doi: 10.1056/NEJMoa1603827
55. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375(4):311-322. doi: 10.1056/NEJMoa1603827
56. Husain M, Bain SC, Mann JFE, et al. No Increased Risk of Heart Failure Hospitalization or Major Cardiovascular Events Observed with Liraglutide in Patients with or without a History of New York Heart Association Class Ii-Iii Heart Failure: Results from the Leader Trial. J Am Coll Cardiol. 2018;71(11):A673. doi: 10.1016/s0735-1097(18)31214-2
57. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. doi: 10.1056/NEJMoa1504720
58. Mahaffey KW, Neal B, Perkovic V, et al. Canagliflozin for Primary and Secondary Prevention of Cardiovascular Events: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study). Circulation. 2018;137(4):323-334. doi: 10.1161/CIRCULATIONAHA.117.032038
59. Rahmoune H, Thompson PW, Ward JM, et al. Glucose Transporters in Human Renal Proximal Tubular Cells Isolated From the Urine of Patients With Non-Insulin-Dependent Diabetes. Diabetes. 2005;54(12):3427-3434. doi: 10.2337/diabetes.54.12.3427
60. Heerspink HJ, Perkins BA, Fitchett DH, et al. Sodium Glucose Cotransporter 2 Inhibitors in the Treatment of Diabetes Mellitus: Cardiovascular and Kidney Effects, Potential Mechanisms, and Clinical Applications. Circulation. 2016;134(10):752-772. doi: 10.1161/CIRCULATIONAHA.116.021887
61. Lambers Heerspink HJ, de Zeeuw D, Wie L, et al. Dapagliflozin a glucose-regulating drug with diuretic properties in subjects with type 2 diabetes. Diabetes Obes Metab. 2013;15(9):853-862. doi: 10.1111/dom.12127
62. Chilton R, Tikkanen I, Cannon CP, et al. Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes. Diabetes Obes Metab. 2015;17(12):1180-1193. doi: 10.1111/dom.12572
63. Fitchett D, Zinman B, Wanner C, et al. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME(R) trial. Eur Heart J. 2016;37(19):1526-1534. doi: 10.1093/eurheartj/ehv728
Review
For citations:
Petunina N.A., Trukhin I.V., Trukhina L.V., Sizova Zh.M., Zakharova V.L. Heart failure and diabetes mellitus: insight into comorbidity. Diabetes mellitus. 2019;22(1):79-87. (In Russ.) https://doi.org/10.14341/DM9784
Views:
1751
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
