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Dapagliflozin Influences Ventricular Hemodynamics and Exercise-Induced Pulmonary Hypertension in Type 2 Diabetes Patients - A Randomized Controlled Trial.

Authors :
Kayano H
Koba S
Hirano T
Matsui T
Fukuoka H
Tsuijita H
Tsukamoto S
Hayashi T
Toshida T
Watanabe N
Hamazaki Y
Geshi E
Murakami M
Aihara K
Kaneko K
Yamada H
Kobayashi Y
Shinke T
Source :
Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2020 Sep 25; Vol. 84 (10), pp. 1807-1817. Date of Electronic Publication: 2020 Sep 12.
Publication Year :
2020

Abstract

Background: This prospective randomized multicenter open-label trial evaluated whether sodium-glucose cotransporter-2 inhibitor (SGLT2-i) improves left ventricular (LV) pump function and suppresses elevation of LV filling pressure (LVFP) and right ventricular systolic pressure (RVSP) during exercise in type 2 diabetes mellitus (T2DM) patients.<br />Methods and results: Based on HbA1c and LV ejection fraction, 78 patients with poorly controlled T2DM were randomly assigned to D-group (dapagliflozin 5 mg/day add-on) or C-group (conventional therapy add-on). Physical examination, home and office blood pressure examination, blood tests, and echocardiography at rest and during ergometer exercise were performed at baseline and at 1.5 and 6 months after treatment. The primary endpoint was defined as the change in RVSP (mmHg) between baseline and 6-month follow up. The secondary endpoints were changes in LVFP (ratio), stroke volume index (SVi; mL/m <superscript>2</superscript> ), and cardiac index (CI; L/min/m <superscript>2</superscript> ). Both RVSP and LVFP during exercise significantly decreased from baseline to 6 months after starting treatment in the D-group (P<0.001). No changes to either parameter was observed in the C-group. The SVi and CI did not improve in either group. Both home and office blood pressure significantly decreased in the D-group. Decreases in HbA1c were somewhat greater in the C-group.<br />Conclusions: Dapagliflozin significantly improved RVSP and LVFP during exercise in patients with T2DM and cardiovascular risk, which may contribute to favorable effects on heart failure.

Details

Language :
English
ISSN :
1347-4820
Volume :
84
Issue :
10
Database :
MEDLINE
Journal :
Circulation journal : official journal of the Japanese Circulation Society
Publication Type :
Academic Journal
Accession number :
32921680
Full Text :
https://doi.org/10.1253/circj.CJ-20-0341