Diabetes mellitus and hemodynamics in advanced heart failure

Benedicte Heegaard, Tania Deis, Kasper Rossing, Mads Ersbøll, Caroline Kistorp, Finn Gustafsson*

*Corresponding author for this work


BACKGROUND: The presence of diabetes in patients with heart failure (HF) is associated with a worse prognosis. It is unclear if hemodynamics in HF patients with DM differ from those of non-diabetic patients and how this might influence outcome. This study aims to discover the impact of DM on hemodynamics in HF patients.

METHODS: Consecutive patients (n = 598) with HF and reduced ejection fraction (LVEF ≤40%) undergoing invasive hemodynamic evaluation were included (non-DM: n = 473, DM: n = 125). Hemodynamic parameters included pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), cardiac index (CI) and mean arterial pressure (MAP). Mean follow-up was 9.5 ± 5.1 years.

RESULTS: Patients with DM (82.7% male, mean age 57.1 ± 10.1 years, mean HbA1c 60 ± 21 mmol/mol) had higher PCWP, mPAP, CVP and higher MAP. Adjusted analysis demonstrated that DM patients had higher PCWP and CVP. Increasing HbA1c-values were correlated with higher PCWP (p = 0.017) and CVP (p = 0.043).

CONCLUSION: Patients with DM, especially those with poor glycemic control, have higher filling pressures. This may be a feature of diabetic cardiomyopathy, however, other unknown mechanisms beyond hemodynamic factors are likely to explain the increased mortality associated with diabetes in HF.

Original languageEnglish
JournalInternational Journal of Cardiology
Pages (from-to)60-65
Number of pages6
Publication statusPublished - 15 May 2023


  • Aged
  • Diabetes Mellitus
  • Female
  • Glycated Hemoglobin
  • Heart Failure/diagnosis
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Wedge Pressure
  • Stroke Volume
  • Heart failure
  • Diabetes mellitus


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