Prognostic impact of diabetes in chronic and acute heart failure

A strong, bidirectional relationship exists between diabetes mellitus (DM) and heart failure (HF) and DM is responsible of the activation of several molecular and pathophysiological mechanisms that may, on the long term, damage the heart. However, the prognostic role of DM in the context of chronic and acute HF is still not yet defined and there are several gaps of evidence in the literature on this topic. These gaps are related to the wide phenotypic heterogeneity of patients with chronic and acute HF and to the concept that not all diabetic patients are the same, but there is the necessity to better characterize the disease and each single patient, also considering the role of other possible comorbidities. The aim of the present review is to summarize the pathophysiological mechanisms subtending the negative effect of DM in HF and analyze the available data exploring the prognostic impact of such comorbidity in both chronic and acute HF.

Automated summary

There is a strong bidirectional relationship between diabetes mellitus (DM) and heart failure (HF), with DM activating multiple molecular and pathophysiological mechanisms that can damage the heart in the long term. However, the prognostic role of DM in chronic and acute HF is still unclear, with gaps in evidence due to the heterogeneity of patient phenotypes and the necessity to better characterize individual patients and their comorbidities. This review aims to summarize the negative impact of DM on HF and analyze available data on the prognostic implications in both chronic and acute HF.