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. 2017 Nov 6;2(1):53-62.
doi: 10.1210/js.2017-00300. eCollection 2018 Jan 1.

Long-Acting GLP-1 Receptor Agonist Exenatide Influence on the Autonomic Cardiac Sympatho-Vagal Balance

Vittorio Cacciatori  1 , Giacomo Zoppini  1 , Federico Bellavere  2 , Riccardo Rigolon  1 , Karl Thomaseth  2 , Isabella Pichiri  1 , Maddalena Trombetta  1 , Marco Dauriz  1 , Francesca De Santi  1 , Giovanni Targher  1 , Lorenza Santi  1 , Enzo Bonora  1
Affiliations

Long-Acting GLP-1 Receptor Agonist Exenatide Influence on the Autonomic Cardiac Sympatho-Vagal Balance

Vittorio Cacciatori et al. J Endocr Soc. .

Abstract

Long-acting glucagon-like peptide 1 receptor agonists are increasingly used to treat type 2 diabetes. An increase of heart rate (HR) has been observed with their use. To elucidate the role of the cardiac sympatho-vagal balance as a possible mediator of the reported increase in HR, we performed power spectral analysis of HR variability (HRV) in patients receiving exenatide extended-release (ER). Twenty-eight ambulatory patients with type 2 diabetes underwent evaluation at initiation of exenatide-ER and thereafter at 3 and at 6 months. To obtain spectral analyses of HRV, a computerized acquisition of 10 minutes of RR electrocardiogram intervals (mean values of ~700 RR intervals) were recorded both in lying and in standing positions. All patients showed a substantial increase of HR both in lying and in standing positions. Systolic blood pressure, body weight, and glycated hemoglobin A1c significantly decreased both at 3 and 6 months compared with basal levels. The low-frequency/high-frequency ratio varied from 3.05 ± 0.4 to 1.64 ± 0.2 (P < 0.001) after 3 months and to 1.57 ± 0.3 (P < 0.001) after 6 months in a lying position and from 4.56 ± 0.8 to 2.24 ± 0.3 (P < 0.001) after 3 months and to 2.38 ± 0.4 (P < 0.001) after 6 months in a standing position compared with basal values, respectively. HR variations, induced by exenatide-ER treatment, do not appear to be related to sympathetic autonomic tone. Of note, we observed a relative increase of vagal influence on the heart.

Keywords: GLP-1 receptor agonist; autonomic nervous system; power spectral analysis.

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Figures

Figure 1.
Figure 1.
Systolic and diastolic blood pressure values before treatment and after 3 and 6 months of therapy in a lying position. Data are expressed as means ± SE. *P < 0.05 and ***P < 0.001 indicate the level of statistical significance (n = 28). ns, not significant.
Figure 2.
Figure 2.
Systolic and diastolic blood pressure values before treatment and after 3 and 6 months of therapy, both in a standing position. Data are expressed as means ± SE. **P < 0.01 and ***P < 0.001 indicate the level of statistical significance (n = 28).
Figure 3.
Figure 3.
LF/HF ratio before treatment and after 3 and 6 months of therapy in LS. Data are expressed as means ± SE. ***P < 0.001 indicates the level of statistical significance (n = 28).
See this image and copyright information in PMC

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