{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:40:57Z","timestamp":1789832457645,"version":"4.0.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,3]]},"abstract":"\n Background<\/jats:title>\n \n Diabetes mellitus frequently coexists with heart failure (\n HF<\/jats:styled-content>\n ), but few studies have compared the associations between diabetes mellitus and cardiac remodeling, quality of life, and clinical outcomes, according to\n HF<\/jats:styled-content>\n phenotype.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We compared echocardiographic parameters, quality of life (assessed by the Kansas City Cardiomyopathy Questionnaire), and outcomes (1\u2010year all\u2010cause mortality, cardiovascular mortality, and\n HF<\/jats:styled-content>\n hospitalization) between\n HF<\/jats:styled-content>\n patients with and without type 2 diabetes mellitus in the prospective\n ASIAN<\/jats:styled-content>\n \u2010\n HF<\/jats:styled-content>\n (Asian Sudden Cardiac Death in Heart Failure) Registry, as well as community\u2010based controls without\n HF<\/jats:styled-content>\n . Adjusted Cox proportional hazards models were used to assess the association of diabetes mellitus with clinical outcomes. Among 5028 patients with\n HF<\/jats:styled-content>\n and reduced ejection fraction (\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n ;\n EF<\/jats:styled-content>\n <40%) and 1139 patients with\n HF<\/jats:styled-content>\n and preserved\n EF<\/jats:styled-content>\n (\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n ;\n EF<\/jats:styled-content>\n \u226550%), the prevalences of type 2 diabetes mellitus were 40.2% and 45.0%, respectively (\n P<\/jats:italic>\n =0.003). In both\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n cohorts, diabetes mellitus (versus no diabetes mellitus) was associated with smaller indexed left ventricular diastolic volumes and higher mitral E\/e\u2032 ratio. There was a predominance of eccentric hypertrophy in\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n and concentric hypertrophy in\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n . Patients with diabetes mellitus had lower\n Kansas City Cardiomyopathy Questionnaire<\/jats:styled-content>\n scores in both\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n , with more prominent differences in\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n (\n P<\/jats:italic>\n interaction<\/jats:sub>\n <0.05). In both\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n , patients with diabetes mellitus had more\n HF<\/jats:styled-content>\n rehospitalizations (adjusted hazard ratio, 1.27; 95%\n CI<\/jats:styled-content>\n , 1.05\u20131.54;\n P<\/jats:italic>\n =0.014) and higher 1\u2010year rates of the composite of all\u2010cause mortality\/\n HF<\/jats:styled-content>\n hospitalization (adjusted hazard ratio, 1.22; 95%\n CI<\/jats:styled-content>\n , 1.05\u20131.41;\n P<\/jats:italic>\n =0.011), with no differences between\n HF<\/jats:styled-content>\n phenotypes (\n P<\/jats:italic>\n interaction<\/jats:sub>\n >0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n , type 2 diabetes mellitus is associated with smaller left ventricular volumes, higher mitral E\/e\u2032 ratio, poorer quality of life, and worse outcomes, with several differences noted between\n HF<\/jats:styled-content>\n phenotypes.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 01633398.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013114","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T05:00:13Z","timestamp":1566363613000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":91,"title":["Association of Diabetes Mellitus on Cardiac Remodeling, Quality of Life, and Clinical Outcomes in Heart Failure With Reduced and Preserved Ejection Fraction"],"prefix":"10.1161","volume":"8","author":[{"given":"Jonathan","family":"Yap","sequence":"first","affiliation":[{"name":"National Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Ting","family":"Tay","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiew\u2010Hwa Katherine","family":"Teng","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore Singapore"},{"name":"School of Population and Global Health University of Western Australia Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inder","family":"Anand","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Mark","family":"Richards","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute National University Heart Centre Singapore"},{"name":"Department of Medicine University of Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieng Hsi","family":"Ling","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute National University Heart Centre Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanchal","family":"Chandramouli","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Tromp","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore Singapore"},{"name":"Department of Cardiology University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bambang B.","family":"Siswanto","sequence":"additional","affiliation":[{"name":"National Cardiovascular Center Universitas Indonesia Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ASIAN\u2010HF (Asian Sudden Cardiac Death in Heart Failure) Registry Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Zile","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Medical University of South Carolina Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McMurray","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences University of Glasgow Glasgow United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S. 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