Key result
Liraglutide fails to improve LV diastolic or systolic function over placebo in type 2 diabetes.
Why the study?
Liraglutide may aid the regression of diabetic cardiomyopathy, and South Asian ethnic groups are especially at risk of developing type 2 diabetes.
Does liraglutide improve LV diastolic and systolic function in South Asian patients with type 2 diabetes?
RCT (n=47)
Double-blind
block size 4, with 1:1 stratification for sex and insulin use
Yes
Does liraglutide improve LV diastolic and systolic function in South Asian patients with type 2 diabetes?
Mean Difference: 0.1 (95% CI -1.2–1.3)
Absolute Event Rate: -0.4% vs -0.3%
p-value: p=0.89
Liraglutide does not improve left ventricular diastolic or systolic function over 26 weeks in South Asian patients with type 2 diabetes.
Liraglutide offers no LV functional benefit in South Asian T2D; challenges assumptions of direct myocardial effects and directs research to other CV pathways.
BACKGROUND: The glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide may be beneficial in the regression of diabetic cardiomyopathy. South Asian ethnic groups in particular are at risk of developing type 2 diabetes. PURPOSE: To assess the effects of liraglutide on left ventricular (LV) diastolic and systolic function in South Asian type 2 diabetes patients. STUDY TYPE: Prospective, double-blind, randomized, placebo-controlled trial. POPULATION: Forty-seven type 2 diabetes patients of South Asian ancestry living in the Netherlands, with or without ischemic heart disease, who were randomly assigned to 26-week treatment with liraglutide (1.8 mg/day) or placebo. FIELD STRENGTH/SEQUENCE: mapping). ASSESSMENT: Primary endpoints were changes in LV diastolic function (early deceleration peak [Edec], ratio of early and late peak filling rate [E/A], estimated LV filling pressure [E/Ea]) and LV systolic function (ejection fraction). Secondary endpoints were changes in aortic stiffness (aortic pulse wave velocity [PWV]), myocardial steatosis (myocardial triglyceride content), and diffuse fibrosis (extracellular volume [ECV]). STATISTICAL TESTS: Data were analyzed according to intention-to-treat. Between-group differences were reported as mean (95% confidence interval [CI]) and were assessed using analysis of covariance (ANCOVA). RESULTS: (-0.3;0.6)), E/A (-0.09 (-0.23;0.05)), E/Ea (+0.1 (-1.2;1.3)) and ejection fraction (0% (-3;2)), but decreased stroke volume (-9 mL (-14;-5)) and increased heart rate (+10 bpm (4;15)). Aortic PWV (+0.5 m/s (-0.6;1.6)), myocardial triglyceride content (+0.21% (-0.09;0.51)), and ECV (-0.2% (-1.4;1.0)) were unaltered. DATA CONCLUSION: Liraglutide did not affect LV diastolic and systolic function, aortic stiffness, myocardial triglyceride content, or extracellular volume in Dutch South Asian type 2 diabetes patients with or without coronary artery disease. LEVEL OF EVIDENCE: 1 Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2020;51:1679-1688.
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Paiman et al. (2019) conducted an RCT in Type 2 diabetes in South Asian patients (n=47). Liraglutide vs. Placebo was evaluated on Change in estimated LV filling pressure (E/Ea) at 26 weeks (MD 0.1, 95% CI -1.2 to 1.3, p=0.89). Liraglutide 1.8 mg/day for 26 weeks did not significantly alter left ventricular diastolic or systolic function compared to placebo in South Asian patients with type 2 diabetes.
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