An Observational Study on the Effect of Canagliflozin on Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital of West Bengal

Background:The incidence of type 2 diabetes mellitus (T2DM) is increasing in India.Left ventricular diastolic dysfunction (LVDD) is a complication of T2DM, which may develop irrespective of glycemic and hypertension control.Sodium-glucose cotransporter 2 (SGLT2) inhibitors, e.g., empagliflozin and canagliflozin have been shown to reduce all-cause mortality including cardiovascular mortality in T2DM patients. Aims and objectives:The aims of this study were to evaluate the effect of canagliflozin on cardiac and renal parameters and improvement of LVDD at the end of 6 months in T2DM patients.Materials and methods: About 100 T2DM patients meeting inclusion and exclusion criteria were put on Canagliflozin (100 mg/day) and followed up for 6 months.Clinicodemographic profiles with blood pressure (BP) and body mass index (BMI) and fasting blood sugar, HbA1c, serum creatinine, eGFR, urine albumin/creatinine ratio (UACR) were assessed at baseline and 6 months.Also, echocardiographic parameters like average E/e' , septal and lateral e' velocity, TR velocity and LA volume index (LAVI) were assessed and statistically analysis by SPSS 22.0 software.Results: Majority of patients were male (56%), aged between 45 and 60 years (57%), and obese (51%).Significant findings were, ( 1) Canagliflozin for 6 months improved E/A in 60 years and LAVI in <45 years' age-group.(2) It improved LAVI in hypertensives and patients of <10 years of disease duration.(3) It improved serum creatinine and UACR.