Lopez J; JFK Hospital, Lantana, Florida, USA.
Liu Y; Butler J; Del Prato S; Ezekowitz JA; Lam CSP; Marwick TH;
Rosenstock J; Tang WHW; Perfetti R; Urbinati A; Zannad F; Januzzi JL Jr;
Ibrahim NE

Journal of the American College of Cardiology. 84(3):233-243, 2024 Jul 16.

BACKGROUND: Diabetic cardiomyopathy (DbCM) increases risk of overt heart
failure in individuals with diabetes mellitus. Racial and ethnic
differences in DbCM remain unexplored.

OBJECTIVES: The authors sought to identify racial and ethnic differences
among individuals with type 2 diabetes mellitus, structural heart disease,
and impaired exercise capacity.

METHODS: The ARISE-HF (Aldolase Reductase Inhibitor for Stabilization of
Exercise Capacity in Heart Failure) trial is assessing the efficacy of an
aldose reductase inhibitor for exercise capacity preservation in 691
persons with DbCM. Baseline characteristics, echocardiographic parameters,
and functional capacity were analyzed and stratified by race and
ethnicity.

RESULTS: The mean age of the study participants was 67.4 years; 50% were
women. Black and Hispanic patients had lower use of diabetes mellitus
treatments. Black patients had poorer baseline ventricular function and
more impaired global longitudinal strain. Overall, health status was
preserved, based on Kansas City Cardiomyopathy Questionnaire scores, but
reduced exercise capacity was present as evidenced by reduced Physical
Activity Scale for the Elderly (PASE) scores. When stratified by race and
ethnicity and compared with the entire cohort, Black patients had poorer
health status, more reduced physical activity, and a greater impairment in
exercise capacity during cardiopulmonary exercise testing, whereas
Hispanic patients also displayed compromised cardiopulmonary exercise
testing functional capacity. White patients demonstrated higher physical
activity and functional capacity.

CONCLUSIONS: Racial and ethnic differences exist in baseline
characteristics of persons affected by DbCM, with Black and Hispanic study
participants demonstrating higher risk features. These insights inform the
need to address differences in the population with DbCM. (Safety and
Efficacy of AT-001 in Patients With Diabetic Cardiomyopathy [ARISE-HF];
NCT04083339).