title: [Diabetes and heart failure: a practically oriented critical appraisal].
abstract: Patients with type 2 diabetes have an increased risk for developing symptoms of                     heart failure. These can be accompanied by a reduction of left ventricular                     ejection fraction (HFREF, systolic heart failure) or by a preserved function                     (HFPEF, diastolic heart failure). The pathophysiology of both entities is                     distinct and involves impairment of myocardial metabolism and coronary                     circulation alike. Although diabetes and heart failure often coincide, the                     management of these patients particularly with respect to the specific benefits                     or possible hazards of antidiabetic treatment is vague. Therefore, from a                     pathophysiological as well as clinical viewpoint, 1) diabetic patients with                     symptoms of heart failure have to be differentiated regarding systolic as well                     as diastolic left ventricular function by echocardiography and tissue doppler                     imaging. 2) Heart failure in diabetic patients needs similar attention due to a                     prognosis and interactions. 3) Optimized blood glucose lowering in combination                     with improvement of other cardiovascular risk factors is evident for HFREF and                     is assumed to be beneficial for HFPEF. 4) Antidiabetic medication has to be                     specifically adapted for both entities. As prospective, controlled studies are                     scarce, future interventional studies should specifically focus on clinical                     outcome in diabetic patients with different entities of heart failure.
authors.affiliation: Zentrum für Prävention und Sportmedizin an der TU München.
authors.forename: M
authors.initials: M
authors.lastname: Halle
authors.forename: A K
authors.initials: AK
authors.lastname: Gitt
authors.forename: M
authors.initials: M
authors.lastname: Hanefeld
authors.forename: M
authors.initials: M
authors.lastname: Kellerer
authors.forename: N
authors.initials: N
authors.lastname: Marx
authors.forename: J J
authors.initials: JJ
authors.lastname: Meier
authors.forename: P-M
authors.initials: PM
authors.lastname: Schumm-Draeger
authors.forename: P
authors.initials: P
authors.lastname: Bramlage
authors.forename: D
authors.initials: D
authors.lastname: Tschoepe
mesh_terms: D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D004452:Echocardiography; D015150:Echocardiography, Doppler; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D054144:Heart Failure, Diastolic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D011379:Prognosis; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
chemical_list: D007004:Hypoglycemic Agents