Effects of Luseogliflozin on Left Ventricular Diastolic Function in Patients with Type 2 Diabetes and Established Cardiovascular Disease.

Background: This study aimed to evaluate the effect of luseogliflozin, an inhibitor of sodium-glucose cotransporter 2 (SGLT2), on left ventricular (LV) diastolic function in patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Methods: We enrolled 25 patients with T2DM and CVD and performed physical examinations, blood tests, and echocardiography before and 24 weeks after luseogliflozin treatment. The primary endpoint was defined as a change in the septal E/e′ ratio as a parameter of LV diastolic function. Results: Luseogliflozin administered for 24 weeks significantly reduced HbA1c levels (8.2 ± 1.2% to 7.4 ± 0.6%, p < 0.01) and systolic blood pressure (125.6 ± 18.1 mmHg to 119.3 ± 16.8 mmHg, p = 0.04) compared to baseline. Luseogliflozin significantly reduced left atrial diameter (42.2 ± 5.7 mm to 39.9 ± 6.8 mm, p = 0.01) and LV diameter (diastolic, 49.5 ± 6.9 mm to 47.6 ± 7.6 mm, p = 0.01; systolic, 35.8 ± 9.1 mm to 33.9 ± 9.8 mm, p < 0.01). Early diastolic mitral annular tissue (e′) velocity and septal E/e′ ratio were significantly improved in the group of e′ velocity < 6.0 cm/sec of baseline (e′ velocity, 4.8 ± 0.6 cm/sec to 5.8 ± 0.9 cm/sec, p < 0.01; septal E/e′ ratio, 13.0 ± 4.9 to 10.9 ± 3.4, p = 0.03, respectively). Conclusions: These results suggest the possibility that luseogliflozin improves overt LV diastolic function in patients with T2DM and CVD.