Welcome to the first episode in a special three-part series of the Diabetes Core Update podcast, focused on heart screening in people with diabetes. Sponsored by Roche, this series explores "heart failure with preserved ejection fraction" (HFpEF), providing primary care clinicians and healthcare professionals with essential insights into screening, diagnosis, and management of this increasingly recognized condition.

Episode Summary

In this episode, host Dr. Neil Skolnik introduces the growing importance of HFpEF in diabetes care and is joined by two esteemed experts:

• Rodica Busui, MD, PhD, professor and chief of the division of endocrinology at the Oregon Health and Science University and past president of the American Diabetes Association for Medicine and Science.
• James Jannuzzi, MD, professor of medicine at Harvard Medical School, staff cardiologist at Massachusetts General Hospital, and senior cardiometabolic faculty at Baim Institute for Clinical Research.

The discussion explores:

1. HFpEF Basics: Definition, prevalence, and how it differs from heart failure with reduced ejection fraction (HFrEF).
2. Pathophysiology: The multifactorial causes of HFpEF, including aging, obesity, diabetes, and more.
3. Diabetes and HFpEF: Why HFpEF should be considered a major complication of diabetes alongside atherosclerotic and microvascular diseases.
4. Screening Recommendations: Insights from the 2022 ADA/ACC Consensus Report, emphasizing early detection through biomarkers like NT-proBNP and annual testing for at-risk patients.

Key Takeaways

• Epidemiology: HFpEF affects at least half of heart failure patients and is increasingly prevalent due to aging, obesity, and diabetes.
• Screening Guidelines: Every person with diabetes, especially those with chronic kidney disease, hypertension, or obesity, should be considered for HFpEF screening.
• Biomarkers: NT-proBNP thresholds are key tools for early diagnosis, with tailored considerations for obesity and other conditions.
• Prevention and Collaboration: Effective risk factor management and team-based care can prevent HFpEF progression and improve outcomes.

Thank you for joining us on this first of a multipart series on early detection and treatment of heart failure with preserved ejection fraction. In the first part of this series, we focused on basics—epidemiology, pathophysiology, and staging—as well as the critically important new recommendations around screening people with diabetes for heart failure.

In the second part of the series, we'll explore treatment strategies for HFpEF.

This special edition of Diabetes Core Update is sponsored by Roche.