Early recognition of heart failure in patients with diabetes type 2 in primary care. A prospective diagnostic efficiency study. (UHFODM2)

Boonman-de Winter, Leandra J. M.; Rutten, Frans H.; Cramer, Maarten J.; Liem, Anho H.; Landman, Marcel J.; van Stel, Henk F.; de Wit, G Ardine; Rutten, Guy E. H. M.; van Hessen, Paulien A. W.; Hoes, Arno W.
January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p479
Academic Journal
Background: We hypothesize that the prevalence of unknown heart failure in diabetic patients aged 60 years and over is relatively high (15% or more) and that a cost-effective strategy can be developed to detect heart failure in these patients. The strategy is expected to include some signs and symptoms (such as dyspnoea, orthopnoea, pulmonary crepitations and laterally displaced apical beat), natriuretic peptide measurements (Amino-terminal B-type natriuretic peptide) and possibly electrocardiography. In a subset of patients straightforward echocardiography may show to be cost-effective. With information from our study the detection of previously unknown heart failure in diabetic patients could be improved and enable the physician to initiate beneficial morbidity and mortality reducing heart failure treatment more timely. Primary objectives: - To assess the prevalence of (previously unrecognised) heart failure in primary care patients with diabetes type 2. - To establish the most cost-effective diagnostic strategy to detect unrecognised heart failure in these patients. Secondary objectives: - To assess the impact of heart failure, and the combination of a new diagnosis with accordingly treatment in patients with diabetes type 2 on health status. Methods/Design: Design: A prospective diagnostic efficiency study. Patient population: Patients aged 60 years and older with diabetes type 2 from primary care, enlisted with the diabetes service of the Diagnostic Center in Etten-Leur (SHL) All participants will be investigated at the cardiology out-patient department of the regional hospital (Oosterschelde Hospital in Goes, Zeeland, the Netherlands) during a single 1.5 hour standardised diagnostic assessment, including history taking, physical examination, electrocardiography, echocardiography, blood tests, and Health status questionnaires. Patients will be asked if we can contact them afterwards for follow-up and for repeating the questionnaires after three and 12 months. Main study parameters/endpoints: Prevalence (with exact 95% confidence intervals) of (previously unrecognised) heart failure (systolic and "isolated" diastolic) and the diagnostic value of signs and symptoms, NT-proBNP, electrocardiography and a combination of these items. The cost-effectiveness of different diagnostic strategies. Impact of heart failure and the combination of a new diagnosis with accordingly treatment on health status. Trial registration: CCMO register NL2271704108


Related Articles

  • Rosiglitazone reduced type 2 diabetes but increased heart failure in patients with impaired glycemic control. Gandhi, Gunjan Y.; Swiglo, Brian A. // ACP Journal Club;Jan/Feb2007, Vol. 146 Issue 1, p8 

    The article cites a study regarding the effectiveness of rosiglitazone for the treatment of type 2 diabetes in patients with impaired glucose tolerance. The study was conducted by researcher H.C. Gerstein and colleagues, and published in the journal "The Lancet." There were few patients with...

  • Pharmacodynamics of β-Blockers in Heart Failure: Lessons from the Carvedilol Or Metoprolol European Trial. Bauman, Jerry L.; Talbert, Robert L. // Journal of Cardiovascular Pharmacology & Therapeutics;Jun2004, Vol. 9 Issue 2, p117 

    This article focuses on the pharmacodynamics of β-blockers in heart failure. Heart failure is a growing public health problem in the United States, and the approach to the treatment of heart failure has undergone a radical transformation in the past decade. The prevalence of heart failure is...

  • Exercise testing predicts death. Pownall, Mark // GP: General Practitioner;11/25/2005, p3 

    The article cites a research study, which reveals that exercise testing is a powerful predictor of long-term mortality in patients with coronary artery disease as well as those with heart failure. This study has been conducted by the researchers at the American Heart Association's Scientific...

  • CHD, heart failure and depression. Newson, Louise // GP: General Practitioner;6/30/2006, p22 

    The article presents information on the latest findings concerning heart care and depression. The CHARM study has shown that adding candesartan is very cost-effective as hospital admissions are significantly reduced. It might well be that angiotensin II receptor blocker are used for most of the...

  • Synergistic Approach Of Applied Physiology & Yoga To Combat Lifestyle Diseases. Sharma, Geetanjali; Sharma, Luv K.; Sood, Sushma // Internet Journal of Alternative Medicine;2009, Vol. 7 Issue 1, p1 

    The modern age is 'the age of stress' and stress related diseases, which pose a serious challenge to not only medical professionals but to the whole concerned diasporas. In spite of the leaps and bounds in medical sciences, we are surrounded by a very silent but dangerous foe, lifestyle...

  • The Association Between Glucose Abnormalities and Heart Failure in the Population-Based Reykjavík Study. Thrainsdottir, Inga S.; Aspelund, Thor; Thorgeirsson, Gudmundur; Gudnason, Vilmundur; Hardarson, Thordur; Malmberg, Klas; Sigurdsson, Gunnar; Rydén, Lars // Diabetes Care;Mar2005, Vol. 28 Issue 3, p612 

    OBJECTIVE -- Diabetes is an independent risk factor for heart failure, whereas the relation between heart failure and abnormal glucose regulation (AGR) needs further evaluation. We studied this combination in the Reykjavík Study. RESEARCH DESIGN AND METHODS -- The Reykjavík Study, a...

  • Impaired Glucose Metabolism in Patients with Heart Failure: Pathophysiology and Possible Treatment Strategies. Tenenbaum, Alexander; Fisman, Enrique Z. // American Journal of Cardiovascular Drugs;2004, Vol. 4 Issue 5, p269 

    The firm association of diabetes mellitus with congestive heart failure (CHF) has been undoubtedly established. Recent reports support the presence of the reciprocal interrelationships between CHF and glucose abnormalities. The present review provides an overview of some aspects of the...

  • Errata.  // Diabetes;Mar2006, Vol. 55 Issue 3, p862 

    Corrections to articles in previous issues including a research on diabetes-accelerated atherosclerosis in the 2004 issue and a study on resistance to diet-induced obesity in the 2005 issue are presented.

  • Study to Leverage iPads for Diabetes Interventions. Goth, Greg // Healthdatamanagement.com;8/25/2014, p1 

    The article reports on the partnerships between North Carolina Translational and Clinical Sciences Institute and South Carolina Clinical and Translational Research Institute to conduct a study regarding ways on how to reduce diabetes prevalence and complications in Bamberg County, South Carolina.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics