Septal Tissue Doppler Velocity and Left Atrial Volume Index as Predictors of Heart Failure with Preserved Ejection Fraction in Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection
fraction (HFpEF). Early detection of diastolic dysfunction in diabetic patients is essential but challenging in
routine practice.
Objective: To determine the prevalence of HFpEF among T2DM patients in a tertiary centre and to evaluate septal
early diastolic mitral annular velocity (septal e′) and left atrial volume index (LAVI) as predictors of HFpEF using
the 2019 Heart Failure Association (HFA)–European Society of Cardiology (ESC) consensus criteria.
Methods: In this cross-sectional study, 201 adults with T2DM under follow-up at Hospital UiTM over six months
were randomly selected. Clinical evaluation, biochemical profiling, N-terminal pro–B-type natriuretic peptide
(NT-proBNP), and comprehensive transthoracic echocardiography were performed. HFpEF was diagnosed using
HFA–ESC 2019 recommendations (symptoms/signs of HF, LVEF ≥50%, structural/functional abnormalities, and
elevated NT-proBNP). Septal e′, LAVI, basal septal hypertrophy, and serum cortisol (exploratory) were assessed.
Group comparisons and multiple linear regression were used to identify independent predictors of HFpEF