Key result
Higher long-term fasting plasma glucose variability was independently associated with a 51.3% decreased likelihood of developing heart failure with improved ejection fraction (OR 0.487) compared to the lowest variability quartile.
Why the study?
Glycemic variability has emerged as a critical cardiometabolic factor, but its relation to the incidence of heart failure with improved ejection fraction remains unclear.
Does high long-term fasting plasma glucose variability reduce the likelihood of developing heart failure with improved ejection fraction in patients with HFrEF?
Cohort (n=519)
No
Does high long-term fasting plasma glucose variability reduce the likelihood of developing heart failure with improved ejection fraction in patients with HFrEF?
Odds Ratio: 0.487 (95% CI 0.257–0.91)
p-value: p=0.025
Greater long-term fasting plasma glucose variability is independently associated with a reduced likelihood of myocardial functional recovery (HFimpEF) in patients with HFrEF, regardless of diabetes status.
High FPG variability was associated with lower HFimpEF likelihood in HFrEF; leaves open whether stabilizing variability aids recovery.
Background: A substantial portion of heart failure (HF) patients adherent to guideline-directed medical therapies have experienced improved ejection fraction (EF), termed HFimpEF. Glycemic variability (GV) has emerged as a critical cardiometabolic factor. However, the relation between long-term GV and the incidence of HFimpEF is still unclear. Methods: A total of 591 hospitalized HF patients with reduced EF (HFrEF, EF≤ 40%) admitted from January 2013 to December 2020 were consecutively enrolled. Repeat echocardiograms were performed at baseline and after around 12 months. The incidence of HFimpEF, defined as (1) an absolute EF improvement ≥10% and (2) a second EF > 40% and its association with long-term fasting plasma glucose (FPG) variability were analyzed. Results: During a mean follow-up of 12.2 ± 0.6 months, 218 (42.0%) patients developed HFimpEF. Multivariate analysis showed FPG variability was independently associated with the incidence of HFimpEF after adjustment for baseline HbA1c, mean FPG during follow-up and other traditional risk factors (odds ratio [OR] for highest vs. lowest quartile of CV of FPG: 0.487 [95% CI 0.257~0.910]). Evaluation of GV by alternative measures yielded similar results. Subgroup analysis revealed that long-term GV was associated with HFimpEF irrespective of glycemic levels and diabetic conditions. Conclusions: This study reveals that greater FPG variability is associated with compromised development of HFimpEF. A more stable control of glycemic levels might provide favorable effects on myocardial functional recovery in HF patients even without diabetes.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2023) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=519). Fasting plasma glucose (FPG) variability vs. Lowest quartile of FPG variability was evaluated on Incidence of heart failure with improved ejection fraction (HFimpEF) (OR 0.487, 95% CI 0.257-0.910, p=0.025). Higher long-term fasting plasma glucose variability was independently associated with a 51.3% decreased likelihood of developing heart failure with improved ejection fraction (OR 0.487) compared to the lowest variability quartile.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: