Type 2 diabetics often harbor undiagnosed heart failure



ROME – Unrecognized heart failure is common among older patients with type 2 diabetes, on the basis of a study of 581 Dutch diabetes patients.

A comprehensive screening examination and assessment of Dutch patients with type 2 diabetes who were at least 60 years old and had no prior history of heart failure identified 161 patients (28%) with heart failure, Dr. Leandra J.M. Boonman-de Winter and her associates reported in a poster at the annual meeting of the European Association for Cardiovascular Prevention and Rehabilitation*.

The newly identified heart failure patients included 28 (5% of the total group screened) with reduced left ventricular function and 133 (23%) with preserved left ventricular function, said Dr. Boonman-de Winter, a researcher at University Medical Center in Utrecht, the Netherlands, and her associates.

To identify these heart failure cases, the researchers performed an extensive work-up on each patient with type 2 diabetes, including a medical history, physical examination, ECG, and echocardiography. A panel of expert cardiologists made the diagnosis of heart failure using criteria of the European Society for Cardiology (Eur. Heart J. 2012;33:1787-847).

The researchers also performed a multivariate analysis to identify demographic and clinical factors that significantly linked with the presence of heart failure in the patients with diabetes. Dyspnea or fatigue linked with a sixfold increased prevalence of heart failure; ankle edema or nocturia, a history of ischemic heart disease, and age greater than 75 years old each linked with a doubled heart-failure prevalence; and hypertension linked with a 70% increased prevalence of heart failure.

These five factors together could account for 80% of the heart failure cases found among the patients with type 2 diabetes, the researchers reported. They recommended using these five factors to identify older patients with diabetes to more thoroughly screen for heart failure.

Dr. Boonman-de Winter and her associates said that they had no disclosures.

On Twitter @mitchelzoler

*Correction, 5/29/2013: An earlier version of this story misstated the meeting name.

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