Prevalence and determination of risk factors of heart failure preserve ejection fraction ( HFpEF) in Type II diabetes mellitus population in Hospital Al-Sultan Abdullah / Ahmad Firdaus Zakaria

Background: Type 2 diabetes mellitus (T2DM) and heart failure are two entities that have reached epidemic proportions worldwide. It has been shown that the prevalence of preserved ejection fraction heart failure (HFpEF) seems to be increasing due to increasing number of metabolic diseases and T2DM. However, the data on prevalence and risk factors are currently limited, particularly within our population.
Objective: The aim of this study was to determine the prevalence and associated factors of HFpEF amongst T2DM patients attending the Endocrinology & Cardiology clinics in Hospital Al-Sultan Abdullah. Method: A cross-sectional study on patients with T2DM of more than 18 years of age, from December 2021 to May 2022 was conducted. Baseline demographic data, anthropometric measurements, echocardiography and NTproBNP levels were obtained.
Results: A total of 262 T2DM patients with a mean age of 61+5.4 years were recruited. The prevalence of HFpEF amongst the study population was 21.7% (n=57). Multiple logistic regression analysis revealed that female gender (p:0.003, OR: 3.053 (CI, 1.107:5.455), chronic kidney disease (p:0.001, OR:3.625(1.537,8.550), anaemia (haemoglobin <12g/dL) (p:<0.008 OR:2.952(1.537,6.530) and use of > 3 antihypertensive medications (p:0.005, OR:2.612(1.345,5.332) were predictors for HFpEF in the study population.
Conclusions: The prevalence of HFpEF diagnosed with abnormal echocardiography findings and elevated NTproBNP as a surrogate marker, was notable in this group of T2DM patients. Female gender, CKD, low haemoglobin, and hypertension patient on 3 or more antihypertensive are demonstrated to be significant predictors. This study underscores the need for early detection, initiation of the necessary treatment for HFpEF and optimisation of the associated factors.