Evidence mapPaperPMID 42578452Full record

Trial reportESC heart failure2026

Type 2 diabetes in heart failure with preserved and mildly reduced ejection fraction: insights from the REDUCE-LAP-HF II trial.

Misha Dagan, Shane Nanayakkara, Anna L Beale, Jan Komtebedde, Uma Mylavarapu, Gerd Hasenfuβ, Sheldon E Litwin, Rajeev Mohan, Thomas M Gorter, Maja Cikes and 5 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Misha DaganDepartment of Cardiology, Alfred Hospital, 55 Commercial Rd, Melbourne, Victoria 3004, Australia.ORCID 0000-0002-2353-9776
Shane NanayakkaraDepartment of Cardiology, Alfred Hospital, 55 Commercial Rd, Melbourne, Victoria 3004, Australia.ORCID 0000-0002-0146-6588
Anna L BealeDepartment of Cardiology, Alfred Hospital, 55 Commercial Rd, Melbourne, Victoria 3004, Australia.ORCID 0000-0002-3802-1961
Jan KomtebeddeCorvia Medical Inc., Tewksbury, MA, USA.
Uma MylavarapuDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Gerd HasenfuβHeart Center, University Medical Center, Göttingen, Germany.
Sheldon E LitwinDepartment of Cardiology, Medical University of South Carolina, Charleston, SC, USA.
Rajeev MohanDivision of Cardiology, Advanced Heart Failure and Mechanical Circulatory Support Program, Pulmonary Hypertension Program, La Jolla, CA, USA.
Thomas M GorterDepartment of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Maja CikesDepartment for Cardiovascular Diseases, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.ORCID 0000-0002-4772-5549
Donald E CutlipBeth Israel Deaconess Medical Center, Baim Institute, Boston, MA, USA.
Scott D SolomonHeart and Vascular Center, Brigham and Women's Hospital, Boston, MA, USA.
Martin B LeonDepartment of Internal Medicine, Columbia University Irving Medical Center/NewYork Presbyterian Hospital, New York, NY, USA.
Sanjiv ShahDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID 0000-0002-5655-8201
David M KayeDepartment of Cardiology, Alfred Hospital, 55 Commercial Rd, Melbourne, Victoria 3004, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsType 2 diabetes mellitus (T2DM) and obesity are the archetypal components of cardiometabolic syndromes associated with heart failure (HF) with preserved or mildly reduced ejection fraction (HFpEF/HFmrEF). The specific contribution of T2DM, independent of obesity, to myocardial adaptations and outcomes remains uncertain. We aimed to explore the obesity-independent contribution of T2DM to cardiac structure, function, central haemodynamics, and outcomes.

methodsWe leveraged the sham-control arm of the REDUCE LAP-HF II trial (n = 312), a prospectively phenotyped cohort of patients with HFpEF/HFmrEF undergoing invasive haemodynamic assessment. Multivariable models were used to adjust for body mass index (BMI) and clinical covariates. Outcomes included cardiovascular (CV) death and total HF events.

resultsT2DM was present in 37% of patients and was associated with higher BMI, chronic kidney disease, and prior HF hospitalization. Obesity was present in 62% of patients and was more prevalent in those with T2DM (70% vs 57%, P = .032). After adjustment for BMI, T2DM remained independently associated with greater left ventricular mass, lower EF, impaired left ventricular global longitudinal strain, reduced right ventricular free-wall strain, and higher resting filling pressures. Over a median of 4.0-year (2.5-5.0) follow-up, T2DM was independently associated with increased risk of HF events or CV death (adjusted hazard ratio: 1.96, 95% confidence interval: 1.28-3.00), driven by HF events, whereas BMI was not independently prognostic.

conclusionsHFpEF/HFmrEF patients with T2DM experience adverse myocardial remodelling, impaired biventricular function, adverse central haemodynamics, and worse clinical outcomes independent of obesity. These findings indicate that T2DM confers additional metabolic burden to the myocardium, beyond that attributable to obesity alone.

Indexed as

Diabetes Mellitus, Type 2Heart FailureHeart VentriclesStroke VolumeVentricular Function, LeftAgedBody Mass IndexFemaleFollow-Up StudiesGlobal Longitudinal StrainHumansMaleMiddle AgedObesityPrognosisProspective StudiesCardiometabolicDiastolic dysfunctionHaemodynamicsMyocardial remodellingObesity

Identifiers

PMID42578452

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.