Key result
SGLT2 inhibitors linked to a ~15% improvement in LV-GLS in T2DM with preserved LVEF.
Why the study?
The effects of SGLT2 inhibitors on cardiac structure and function were not fully understood.
Does SGLT2 inhibitor therapy improve global longitudinal strain and myocardial work in well-controlled T2DM patients with preserved LVEF?
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.
May support SGLT2 inhibitor use for subclinical LV dysfunction in preserved-LVEF T2DM; leaves open randomized outcome confirmation.
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.
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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.
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