Key result
Liraglutide treatment increased diurnal variation in hourly mean HR (P=0.011) and mean daytime HR, with no changes in sympathetic or parasympathetic activity compared to glimepiride.
Why the study?
Reduced HRV and increased HR associate with CV mortality, prompting investigation into the effects of liraglutide versus glimepiride on HR and HRV in T2D patients following demonstrated CV event reductions with liraglutide.
Does liraglutide compared with glimepiride alter heart rate and heart rate variability in patients with type 2 diabetes treated with metformin?
RCT (n=62)
Open-label
parallel-group
Does liraglutide compared with glimepiride alter heart rate and heart rate variability in patients with type 2 diabetes treated with metformin?
p-value: p=0.011
Liraglutide increases mean daytime heart rate and diurnal variation compared to glimepiride in type 2 diabetes, without significantly altering sympathetic or parasympathetic activity.
Liraglutide may raise daytime heart rate without autonomic shifts in diabetes; leaves open effects on cardiovascular outcomes.
AIMS: Reduced heart rate variability (HRV) and increased heart rate (HR) are associated with cardiovascular (CV) mortality. In the Liraglutide Effect and Action in Diabetes outcome trial, it was demonstrated a lower rate of CV events in type 2 diabetes (T2D) patients treated with liraglutide compared to placebo. We aimed to investigate the effects of liraglutide compared with glimepiride treatment in T2D patients on the CV risk parameters HR and HRV. METHODS: This was a post hoc study whereas sixty-two T2D individuals (45 males) were randomized to once daily 1.8 mg liraglutide or once daily 4 mg glimepiride, both in combination with 1 g metformin. HR and measurement of sympathetic activity, that is standard deviation (SD) of beat-to-beat (NN) intervals (SDNN), was assessed by 24-hour Holter monitoring system. Parasympathetic activity was analysed by root mean square of successive differences (RMSSD) in NN intervals and high-frequency (HF), low-frequency (LF) and very low-frequency power. RESULTS: = 0.011 in the liraglutide-treated group. There was no treatment change between groups in SDNN and RMSSD, or in HF and LF frequency power analysis. CONCLUSIONS: Liraglutide treatment increased diurnal variation in hourly mean HR followed by an increase in mean daytime HR, independently of changes in sympathetic or parasympathetic activity.
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Nyström et al. (2019) conducted an RCT in Type 2 diabetes (n=62). Liraglutide vs. Glimepiride 4 mg once daily was evaluated on Heart rate (HR) and heart rate variability (HRV) parameters (p=0.011). Liraglutide treatment increased diurnal variation in hourly mean HR (P=0.011) and mean daytime HR, with no changes in sympathetic or parasympathetic activity compared to glimepiride.
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