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. 2023 Oct 23;12(20):6698.
doi: 10.3390/jcm12206698.

Dapagliflozin Improved Cardiac Function and Structure in Diabetic Patients with Preserved Ejection Fraction: Results of a Single Centre, Observational Prospective Study

Marcelino Cortés  1 , Oscar Lorenzo  2   3 , Jairo Lumpuy-Castillo  2   3 , Sacramento Martínez-Albaladejo  2   3 , Mikel Taibo-Urquía  1 , Ana María Pello  1 , Antonio José Bollas  1 , Miguel Orejas  1 , Miguel Ángel Navas  1 , Ester Macia  1 , María Esther Martínez  1 , Andrea Rueda  1 , Jose Tuñón  1
Affiliations

Dapagliflozin Improved Cardiac Function and Structure in Diabetic Patients with Preserved Ejection Fraction: Results of a Single Centre, Observational Prospective Study

Marcelino Cortés et al. J Clin Med. .

Abstract

Sodium-glucose cotransporter inhibitors (SGLT2i) have demonstrated a reduction in cardiovascular events in diabetes and heart failure (HF). The mechanisms underlying this benefit are not well known and data are contradictory. The purpose of this study is to analyse the effect of dapagliflozin on cardiac structure and function in patients with normal ejection fraction. Between October 2020 and October 2021, we consecutively included 31 diabetic patients without prior history of SGLT2i use. In all of them, dapagliflozin treatment was started. At inclusion and during six months of follow-up, different clinical, ECG, analytical, and echocardiographic (standard, 3D, and speckle tracking) variables were recorded. After a follow-up period of 6.6 months, an average reduction of 18 g (p = 0.028) in 3D-estimated left ventricle mass was observed. An increase in absolute left ventricle global longitudinal strain (LV-GLS) of 0.3 (p = 0.036) was observed, as well as an increase in isovolumetric relaxation time (IVRT) of 10.5 ms (p = 0.05). Moreover, dapagliflozin decreased the levels of plasma creatin-kinase (CK-MB) and atrial natriuretic peptide (ANP). In conclusion, our data show that the use of SGLT2i is associated with both structural (myocardial mass) and functional (IVRT, LV-GLS) cardiac improvements in a population of diabetic patients with normal ejection fraction.

Keywords: biomarkers; dapagliflozin; echocardiography; sodium-glucose cotransporter type 2 inhibitors; speckle tracking.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pharmacological treatment of the study population at inclusion. ACEI: angiotensin-converting enzyme inhibitors; ARB: angiotensin receptor blocker; HT: hypertension.
Figure 2
Figure 2
Changes in left ventricle mass, global longitudinal strain, E/e’ ratio, and ANP after dapagliflozin treatment. Dapagliflozin is associated with greater reduction in 3D-left ventricular mass (A), left ventricular global longitudinal strain (B), with the E/e’ ratio (C), and with the ANP plasma levels (D). Graphs represent mean and 95% confidence interval.
Figure 3
Figure 3
Association between biomarkers and echocardiographic variables: data matrix.∆: absolute difference from baseline; ρ: Spearman’s rho (correlation coefficient); r = Pearson’s r (correlation coefficient). ANP: atrial natriuretic peptide; BMI: body mass index; CK-MB: creatinine phosphokinase-MB; IVRT: isovolumic relaxation time; LV: left ventricle; LVEDV: LV end-diastolic volume; LV GLS: LV global longitudinal strain.
See this image and copyright information in PMC

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