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Model of diabetic heart failure (HF) progression. The diabetic metabolic environment promotes adverse cardiac remodeling, including the development of left ventricular hypertrophy (LVH) and diastolic dysfunction. This stage is often asymptomatic. Over time and often in the face of other co-morbidities, heart failure with either preserved ejection fraction (HFpEF) or reduced ejection fraction (HFrEF) can occur.
