Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) are a novel class of oral hypoglycemic agents currently used among patients with type 2 diabetes mellitus (T2DM). The effects of SGLT2-i inhibitors on cardiac structure and function are not fully understood. The aim of this study is to evaluate the echocardiographic changing among patients with well-controlled T2DM treated with SGLT2-i in real-world setting. Thirty-five well-controlled T2DM patients (65 6 9 years, 43.7% male) with preserved left ventricular ejection fraction (LVEF) and 35 age and sex-matched controls were included. T2DM patients underwent clinical and laboratory evaluation; 12-lead surface electrocardiogram; 2-dimensional color Doppler echocardiography at enrolment, before SGLT2-i administration, and at 6 months follow-up after an uninterrupted 10 mg once daily of empagliflozin (n: 21) or dapagliflozin (n: 14). Standard echocardiographic measurements, LV global longitudinal strain (LV-GLS), global wasted work, and global work efficiency were calculated. T2DM patients showed higher E\E' ratio (8.3 +/- 2.5 vs. 6.3 +/- 0.9; P, 0.0001) and lower LV-GLS (15.8 +/- 8.1 vs. 22.1 +/- 1.4%; P, 0.0001) and global myocardial work efficiency (91 +/- 4 vs. 94 +/- 3%; P: 0.0007) compared with age and sex-matched controls. At 6-month follow-up, T2DM patients showed a significant increase in LVEF (58.9 +/- 3.2 vs. 62 +/- 3.2; P, 0.0001), LV-GLS (16.2 +/- 2.8 vs. 18.7 +/- 2.4%; P = 0.003), and global work efficiency (90.3 +/- 3.5 vs. 93.3 +/- 3.2%; P = 0.0004) values; conversely, global wasted work values (161.2 +/- 33.6 vs. 112.72 +/- 37.3 mm Hg%; P, 0.0001) significantly decreased. Well-controlled T2DM patients with preserved LVEF who are treated with a SGLT2-i on top of the guidelines direct medical therapy showed a favorable cardiac remodeling, characterized by the improvement of LV-GLS and myocardial work efficiency.
Improvement of Global Longitudinal Strain and Myocardial Work in Type 2 Diabetes Patients on Sodium-Glucose Cotransporter 2 Inhibitors Therapy
Russo, Vincenzo;Caturano, Alfredo;Fabiani, Dario;Del Giudice, Carmen;Nigro, Gerardo;Golino, Paolo;
2023
Abstract
Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) are a novel class of oral hypoglycemic agents currently used among patients with type 2 diabetes mellitus (T2DM). The effects of SGLT2-i inhibitors on cardiac structure and function are not fully understood. The aim of this study is to evaluate the echocardiographic changing among patients with well-controlled T2DM treated with SGLT2-i in real-world setting. Thirty-five well-controlled T2DM patients (65 6 9 years, 43.7% male) with preserved left ventricular ejection fraction (LVEF) and 35 age and sex-matched controls were included. T2DM patients underwent clinical and laboratory evaluation; 12-lead surface electrocardiogram; 2-dimensional color Doppler echocardiography at enrolment, before SGLT2-i administration, and at 6 months follow-up after an uninterrupted 10 mg once daily of empagliflozin (n: 21) or dapagliflozin (n: 14). Standard echocardiographic measurements, LV global longitudinal strain (LV-GLS), global wasted work, and global work efficiency were calculated. T2DM patients showed higher E\E' ratio (8.3 +/- 2.5 vs. 6.3 +/- 0.9; P, 0.0001) and lower LV-GLS (15.8 +/- 8.1 vs. 22.1 +/- 1.4%; P, 0.0001) and global myocardial work efficiency (91 +/- 4 vs. 94 +/- 3%; P: 0.0007) compared with age and sex-matched controls. At 6-month follow-up, T2DM patients showed a significant increase in LVEF (58.9 +/- 3.2 vs. 62 +/- 3.2; P, 0.0001), LV-GLS (16.2 +/- 2.8 vs. 18.7 +/- 2.4%; P = 0.003), and global work efficiency (90.3 +/- 3.5 vs. 93.3 +/- 3.2%; P = 0.0004) values; conversely, global wasted work values (161.2 +/- 33.6 vs. 112.72 +/- 37.3 mm Hg%; P, 0.0001) significantly decreased. Well-controlled T2DM patients with preserved LVEF who are treated with a SGLT2-i on top of the guidelines direct medical therapy showed a favorable cardiac remodeling, characterized by the improvement of LV-GLS and myocardial work efficiency.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
