ArticleCardiovascular diabetology2022
Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry.
Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Meta-analysis of the effects of different exercise modes on cardiac function and peak oxygen uptake in patients with type 2 diabetes mellitus.Frontiers in physiology · 2024Pooled it
- Comprehensive CMR evaluation including 4D flow-derived E/A vorticity ratio in overweight adults with and without type 2 diabetes mellitus.Cardiovascular diabetology · 2025Trial
- Associations between cardiometabolic traits and diabetic cardiomyopathy: an imaging-based analysis.Acta diabetologica · 2026Article
- Risk calculator of multimorbid risk of rehospitalization and death from heart failure: including the contribution of the gut microbiome.European journal of preventive cardiology · 2026Article
- Beyond the left ventricle: Right ventricular dysfunction as a critical determinant in type 1 diabetes-related cardiomyopathy.World journal of diabetes · 2025Article
- Right ventricular dysfunctions in type 1 diabetic mice: A longitudinal study.World journal of diabetes · 2025Article
- Right ventricular-pulmonary coupling and tissue hypoperfusion: a combined echocardiographic and metabolic approach to prognosticate cardiogenic shock.BMC cardiovascular disorders · 2025Article
- Associations between the triglyceride-glucose index and the risk of heart failure in patients undergoing maintenance hemodialysis: a retrospective cohort study.Frontiers in endocrinology · 2025Article
- Insulin-Heart Axis: Bridging Physiology to Insulin Resistance.International journal of molecular sciences · 2024Review
- Association between subclinical right ventricular alterations and aerobic exercise capacity in type 2 diabetes.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Article
- Progress in Cardiac Magnetic Resonance Feature Tracking for Evaluating Myocardial Strain in Type-2 Diabetes Mellitus.Current diabetes reviews · 2024Review
- Endothelial Dysfunction and Heart Failure with Preserved Ejection Fraction-An Updated Review of the Literature.Life (Basel, Switzerland) · 2023Review
- The impact of sacubitril/valsartan on outcome in patients suffering from heart failure with a concomitant diabetes mellitus.ESC heart failure · 2023Article
- Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature.Journal of cardiovascular development and disease · 2022Review
Corrections and comments
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Authors and funding
31 authors at 20 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFindings from the T.O.S.CA. Registry recently reported that patients with concomitant chronic heart failure (CHF) and impairment of insulin axis (either insulin resistance-IR or diabetes mellitus-T2D) display increased morbidity and mortality. However, little information is available on the relative impact of IR and T2D on cardiac structure and function, cardiopulmonary performance, and their longitudinal changes in CHF.
methodsPatients enrolled in the T.O.S.CA. Registry performed echocardiography and cardiopulmonary exercise test at baseline and at a patient-average follow-up of 36 months. Patients were divided into three groups based on the degree of insulin impairment: euglycemic without IR (EU), euglycemic with IR (IR), and T2D.
resultsCompared with EU and IR, T2D was associated with increased filling pressures (E/e'ratio: 15.9 ± 8.9, 12.0 ± 6.5, and 14.5 ± 8.1 respectively, p < 0.01) and worse right ventricular(RV)-arterial uncoupling (RVAUC) (TAPSE/PASP ratio 0.52 ± 0.2, 0.6 ± 0.3, and 0.6 ± 0.3 in T2D, EU and IR, respectively, p < 0.05). Likewise, impairment in peak oxygen consumption (peak VO
conclusionThe higher risk of death and CV hospitalizations exhibited by HF-T2D patients in the T.O.S.CA. Registry is associated with progressive RV ventricular dysfunction and exercise impairment when compared to euglycemic CHF patients, supporting the pivotal importance of hyperglycaemia and right chambers in HF prognosis. Trial registration ClinicalTrials.gov identifier: NCT023358017.
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