The ARISE-HF trial provides baseline data on individuals with type 2 diabetes mellitus (T2DM) and features of stage B heart failure (HF), aiming to characterize diabetic cardiomyopathy (DbCM). Among 691 participants, the mean age was 67.4 years, with 50% female. The mean duration of T2DM was 14.5 years, and most had well-controlled glycemia (HbA1c 6.98%). Common echocardiographic findings included reduced global longitudinal strain (25.3%) and impaired diastolic relaxation (17.7%). Despite relatively preserved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, average Physical Activity Scale for the Elderly (PASE) score was 155, indicating reduced physical activity. Average maximal oxygen consumption (VO2max) was 15.7 mL/kg/min, below the 5th percentile for age. K-means clustering identified four phenogroups, with the highest-risk group showing more advanced age, elevated cardiac biomarkers, and evidence of diastolic dysfunction and left ventricular hypertrophy. The study highlights the clinical heterogeneity of DbCM and the importance of identifying distinct phenotypes for targeted treatment. The findings suggest that DbCM is a form of stage B HF, with features that may progress to overt HF. The trial data may help clarify the diagnosis of DbCM and inform treatment strategies. The study also underscores the need for further research to better understand the clinical presentation and progression of DbCM. The ARISE-HF trial is evaluating the safety and efficacy of a novel aldose reductase inhibitor (AT-001) in improving exercise capacity in individuals with DbCM. The results provide a foundation for future analyses of the trial's outcomes.The ARISE-HF trial provides baseline data on individuals with type 2 diabetes mellitus (T2DM) and features of stage B heart failure (HF), aiming to characterize diabetic cardiomyopathy (DbCM). Among 691 participants, the mean age was 67.4 years, with 50% female. The mean duration of T2DM was 14.5 years, and most had well-controlled glycemia (HbA1c 6.98%). Common echocardiographic findings included reduced global longitudinal strain (25.3%) and impaired diastolic relaxation (17.7%). Despite relatively preserved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, average Physical Activity Scale for the Elderly (PASE) score was 155, indicating reduced physical activity. Average maximal oxygen consumption (VO2max) was 15.7 mL/kg/min, below the 5th percentile for age. K-means clustering identified four phenogroups, with the highest-risk group showing more advanced age, elevated cardiac biomarkers, and evidence of diastolic dysfunction and left ventricular hypertrophy. The study highlights the clinical heterogeneity of DbCM and the importance of identifying distinct phenotypes for targeted treatment. The findings suggest that DbCM is a form of stage B HF, with features that may progress to overt HF. The trial data may help clarify the diagnosis of DbCM and inform treatment strategies. The study also underscores the need for further research to better understand the clinical presentation and progression of DbCM. The ARISE-HF trial is evaluating the safety and efficacy of a novel aldose reductase inhibitor (AT-001) in improving exercise capacity in individuals with DbCM. The results provide a foundation for future analyses of the trial's outcomes.