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Effects of empagliflozin in different phases of diabetes mellitus-related cardiomyopathy: a prospective observational study
- Source :
- BMC Cardiovascular Disorders, BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-11 (2021)
- Publication Year :
- 2020
-
Abstract
- Background Diabetes mellitus-related cardiomyopathy (DMCMP), defined as left ventricular (LV) dysfunction caused by hyperglycemia in the absence of coronary artery disease, leads to heart failure (HF). Previous studies have shown that treatment with sodium-glucose co-transporter 2 inhibitor (SGLT2i) reduces the risk of exacerbation of HF. The beneficial effects of SGLT2i on HF depend not only on indirect actions such as osmotic diuresis but also on direct actions on the myocardium, leading to improvements in LV function. However, it remains unclear whether SGLT2i treatment is equally effective in any phase of DMCMP. The aim of this observational study was to compare the efficacy of SGLT2i treatment on LV dysfunction between early and advanced DMCMP. Methods Thirty-five symptomatic non-ischemic HF patients with LV ejection fraction > 40% and type 2 diabetes mellitus (T2DM) treated with empagliflozin (EMPA group) and 20 controls treated without SGLT2i were enrolled. According to the myocardial extracellular volume fraction (ECV), a reliable marker of cardiac fibrosis quantified by cardiac magnetic resonance, the EMPA group was further divided into early DMCMP (n = 16, ECV ≤ 30%) and advanced DMCMP (n = 19, ECV > 30%) groups and followed up prospectively. Echocardiography was performed at baseline and after 12 months. LV function assessed as LV global longitudinal strain (LVGLS) and the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity (E/e′) were compared. Results ECV was strongly correlated with T2DM duration (r2 = 0.65, p p = 0.005, and 4.6 ± 1.5% (early DMCMP) vs. 1.6 ± 3.3% (advanced DMCMP), p = 0.003) and E/e′ (ΔE/e′: − 1.5 ± 4.7 vs. − 0.3 ± 3.0, p = 0.253, and − 3.4 ± 5.5 vs. − 0.1 ± 3.5, p = 0.043). Conclusions The positive effects of empagliflozin on LV dysfunction were more remarkable in early than in advanced DMCMP. Early intervention of SGLT2i for DMCMP may be preferable.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Exacerbation
Diabetic Cardiomyopathies
Cardiomyopathy
Heart failure
030204 cardiovascular system & hematology
Ventricular Function, Left
Coronary artery disease
03 medical and health sciences
Ventricular Dysfunction, Left
0302 clinical medicine
Glucosides
Diabetes mellitus
Internal medicine
medicine
Empagliflozin
Left ventricular global longitudinal strain
Diseases of the circulatory (Cardiovascular) system
Humans
030212 general & internal medicine
Prospective Studies
Benzhydryl Compounds
Sodium-Glucose Transporter 2 Inhibitors
Angiology
Aged
Left ventricular dysfunction
business.industry
Sodium–glucose co-transporter 2 inhibitor
Recovery of Function
Middle Aged
medicine.disease
Diabetes mellitus-related cardiomyopathy
Cardiac surgery
Treatment Outcome
Diabetes Mellitus, Type 2
RC666-701
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Research Article
Subjects
Details
- ISSN :
- 14712261
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC cardiovascular disorders
- Accession number :
- edsair.doi.dedup.....2e90625afe058ea911725a4c7e9cc554