Heart Failure With Preserved Ejection Fraction and Diabetes: JACC State-of-the-Art Review

Kelly McHugh, Adam D. DeVore, Jingjing Wu, Roland A. Matsouaka, Gregg C. Fonarow, Paul A. Heidenreich, Clyde W. Yancy, Jennifer B. Green, Natasha Altman, Adrian F. Hernandez*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

175 Scopus citations


Heart failure with preserved ejection fraction (HFpEF) is now the most common form of HF, affecting over 3 million adults in the United States alone. HFpEF is a heterogenous syndrome. One important phenotype may be related to comorbid conditions, including diabetes mellitus (DM). DM has a prevalence of approximately 45% in HFpEF, but characteristics and outcomes of this population are poorly understood. In this review, the authors summarize data from several clinical trials of HFpEF therapeutics and provide original data from a large cohort using the Get With The Guidelines-HF registry, which together suggest that DM is associated with increased morbidity and long-term mortality in HFpEF. The authors then discuss several common pathological mechanisms in HFpEF and DM, including sodium retention, metabolic derangements, impaired skeletal muscle function, and potential therapeutic targets. As the understanding of comorbid HFpEF and DM improves, it is hoped clinicians will be better equipped to offer effective, patient-centered treatments.

Original languageEnglish (US)
Pages (from-to)602-611
Number of pages10
JournalJournal of the American College of Cardiology
Issue number5
StatePublished - Feb 12 2019


  • clinical trials
  • comorbidity
  • heart failure
  • registries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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