SGLT2 inhibitor therapy in well-controlled T2DM patients with preserved LVEF significantly improved LV global longitudinal strain from 16.2% to 18.7% (P=0.003) at 6 months.
Observational (n=70)
Does SGLT2 inhibitor therapy improve global longitudinal strain and myocardial work in well-controlled T2DM patients with preserved LVEF?
SGLT2 inhibitors improve subclinical left ventricular dysfunction, as measured by global longitudinal strain and myocardial work, in patients with well-controlled type 2 diabetes and preserved ejection fraction.
Absolute Event Rate: 18.7% vs 16.2%
p-value: p=0.003
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 ± 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' 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.
Russo et al. (2023) conducted an observational in Type 2 diabetes mellitus with preserved LVEF (n=70). SGLT2 inhibitors (empagliflozin or dapagliflozin) vs. Baseline was evaluated on LV global longitudinal strain (LV-GLS) (p=0.003). SGLT2 inhibitor therapy in well-controlled T2DM patients with preserved LVEF significantly improved LV global longitudinal strain from 16.2% to 18.7% (P=0.003) at 6 months.