Diabetic cardiomyopathy: An expression of stage B heart failure with preserved ejection fraction
Abstract
Heart failure is now recognized as a progressive disease in which patients transition through the stages of being at risk of heart failure (stage A), to asymptomatic structural heart disease (stage B), to clinical manifestations of heart failure (stage C) and finally end-stage or refractory heart failure (stage D). This review outlines the key role of diabetes mellitus as a stage A risk factor for heart failure with preserved ejection fraction, and asymptomatic diabetic cardiomyopathy, referring to the presence of left ventricular diastolic dysfunction in diabetic patients without coronary artery disease, hypertension or other potential aetiologies, as an expression of stage B heart failure with preserved ejection fraction at high risk of transitioning to symptomatic stage C heart failure with preserved ejection fraction. The data presented call for better recognition of the unique phenotype of diabetic cardiomyopathy with preserved ejection fraction and elevated diastolic stiffness as a manifestation of stage B heart failure with preserved ejection fraction that should be targeted for risk management and preventive strategies.
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As DCM enters its later stage, it progresses from diastolic dysfunction to overt stage C heart failure with preserved ejection fraction, which has no proven effective treatment.
“As DCM enters its later stage, it progresses from diastolic dysfunction to overt stage C heart failure with preserved ejection fraction, which has no proven effective treatment [7], thus validating the importance of identifying biomarkers that can improve detection of DCM prior to the onset of irreversible complications.”
From Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population (2016) · cites this paper as [7]
Diabetes is a condition of risk for HFpEF that may evolve over time in asymptomatic LV diastolic dysfunction and finally in the symptomatic stage of HFpEF.
“Lam outlined the importance of considering diabetes as a condition of risk for HFpEF that may evolve over time in asymptomatic LV diastolic dysfunction and finally in the symptomatic stage of HFpEF [78].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [78]
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- Authors
- Lam, C. S.
- Affiliations
- National University of Singapore (SG)
- Corresponding author
- Lam, Carolyn SP
- ORCID
- Lam, Carolyn SP
- Venue
- Diabetes and Vascular Disease Research
- Publisher
- SAGE Publications
- Published
- 2015-04-23
- Volume
- 12
- Issue
- 4
- Pages
- 234-238
- ISSN
- 1479-1641 (ISSN-L)
- 1752-8984
- OpenAlex
- W2165549211
- Cited by
- 69
- References
- 29
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 7 · 2021: 11 · 2020: 4 · 2019: 4 · 2018: 9 · 2017: 7 · 2016: 6 · 2015: 5
- FWCI
- 6.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes and Vascular Disease Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetic cardiomyopathy, heart failure with preserved ejection fraction, stage B heart failure, left ventricular diastolic dysfunction, diastolic stiffness, diabetes mellitus, heart failure risk, heart failure prevention
- MeSH terms
- Diabetes Mellitus, Heart Failure, Humans, Risk Factors, Stroke Volume, Ventricular Dysfunction, Left, Risk Assessment, Heart Failure, Diastolic, Diabetic Cardiomyopathies, Asymptomatic Diseases
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