What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes mellitus. Intervention: Prognostic utility of clinical parameters including NT-proBNP. Primary outcome: Incident HF, defined as new-onset HF (requiring either hospitalization or an urgent care visit).

What question did this study set out to answer?

To evaluate how risk factors contribute to the development of heart failure in asymptomatic patients with type 2 diabetes and identify predictive clinical parameters.

May 8, 2026Open Access

Prediction of incident heart failure in type 2 diabetes mellitus: Rationale and design of the DM ‐ HEART study

Key Result

The DM-HEART study is a prospective cohort study designed to assess the incidence of heart failure and the prognostic utility of NT-proBNP in asymptomatic patients with type 2 diabetes.

Key Points

To evaluate how risk factors contribute to the development of heart failure in asymptomatic patients with type 2 diabetes and identify predictive clinical parameters.
Prospective, multicenter, longitudinal cohort study design
Recruited asymptomatic patients with type 2 diabetes and no prior heart failure
Minimum follow-up period of 12 months
Primary outcome is incident heart failure requiring hospitalization or urgent care
Secondary outcomes include 3-point major adverse cardiovascular events like cardiovascular death and myocardial infarction
Assesses the prognostic utility of NT-proBNP for predicting heart failure events

Study Design

Type

Cohort

Multicenter

Yes

Structured PICO

Can clinical parameters including NT-proBNP predict incident heart failure in asymptomatic East Asian patients with type 2 diabetes?

Population

Asymptomatic East Asian patients with type 2 diabetes (T2D) and no prior heart failure (preclinical stages A and B HF).

Intervention

Assessment of clinical parameters, including N-terminal pro-B-type natriuretic peptide (NT-proBNP)

Outcome

Incident HF, defined as new-onset HF (requiring either hospitalization or an urgent care visit)hard clinical

The DM-HEART study is designed to assess the prognostic utility of NT-proBNP and other clinical parameters for predicting incident heart failure in asymptomatic East Asian patients with type 2 diabetes.

Abstract

Preclinical heart failure (HF) (stages A and B) is common but easily overlooked in asymptomatic patients with type 2 diabetes (T2D). There is a paucity of evidence regarding how coexisting risk factors contribute to the development of HF in asymptomatic Asian patients with T2D, and there is a lack of guidance on the early identification of asymptomatic patients to help cost-effectively allocate preventive therapies. The Diabetes Mellitus Heart Failure Events Analysis and Risk Tracking (DM-HEART) trial, a prospective, multicenter, longitudinal cohort study, recruited asymptomatic patients with T2D and no prior HF between January 2021 and June 2024, with a minimum follow-up period of 12 months. The primary outcome was incident HF, defined as new-onset HF (requiring either hospitalization or an urgent care visit). Secondary outcomes are measured as 3-point major adverse cardiovascular events, comprised of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. DM-HEART will provide epidemiological data on the incidence of HF and assess the prognostic utility of clinical parameters, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), for predicting incident HF events among asymptomatic patients with T2D in preclinical stages of HF. Furthermore, we aim to determine the optimal NT-proBNP cut-off value for predicting incident HF events in East Asian patients with diabetes.