Higashikawa Toshihiro, Ito Tomohiko, Mizuno Takurou, Ishigami Keiichirou, Kohori Masaru, Mae Kunihiro, Usuda Daisuke, Takagi Susumu, Sangen Ryusho, Saito Atsushi, Iguchi Masaharu, Kasamaki Yuji, Fukuda Akihiro, Kanda Tsugiyasu, Okuro Masashi
Kanazawa Medical University Himi Municipal Hospital, Kurakawa, Himi, Toyama 935-8531, Japan.
Department of Geriatric Medicine, Kanazawa Medical University, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan.
J Clin Med Res. 2020 Mar;12(3):165-171. doi: 10.14740/jocmr4098. Epub 2020 Mar 2.
Patients with type 2 diabetes mellitus (T2DM) are at increased risk for impairments in diastolic relaxation and heart failure with preserved ejection fraction (EF). Recent clinical data suggest that several sodium glucose transporter-2 (SGLT2) inhibitors are found to reduce cardiovascular disease (CVD) events in elderly diabetic patients, but the effect of tofogliflozin, one of the SGLT2 inhibitors, on CVD is unknown. We retrospectively investigated the effect of tofogliflozin on cardiac function in elderly patients with T2DM.
Patients received 20 mg of tofogliflozin daily for 1 month. EF, ratio of early filling to atrial filling (E/A), a change in mitral inflow E and mitral e' annular velocities (E/e'), left atrial dimension (LAD) and maximal diameter of inferior vena cava (IVC) were measured between baseline and 1 month after the administration of tofogliflozin.
Body weight, systolic and diastolic blood pressures significantly decreased, while renin and aldosterone level significantly increased after 1 month of tofogliflozin treatment. Most of the physiological parameters and the level of serum electrolyte did not change significantly. E/A, E/e' and LAD significantly decreased, while no significant changes were observed in EF and IVC. The interactions of E/e' between time, gender and age were not significant.
The present study suggested that tofogliflozin improved left ventricular diastolic function irrespective of gender and age, while preserving IVC, renal function and electrolyte balance.
2型糖尿病(T2DM)患者舒张期松弛功能受损及射血分数保留的心力衰竭风险增加。近期临床数据表明,几种钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂可降低老年糖尿病患者的心血管疾病(CVD)事件,但SGLT2抑制剂之一的托格列净对CVD的影响尚不清楚。我们回顾性研究了托格列净对老年T2DM患者心脏功能的影响。
患者每日服用20 mg托格列净,持续1个月。在基线和服用托格列净1个月后,测量射血分数(EF)、早期充盈与心房充盈比值(E/A)、二尖瓣流入E峰变化和二尖瓣e'环速度(E/e')、左心房内径(LAD)和下腔静脉最大直径(IVC)。
托格列净治疗1个月后,体重、收缩压和舒张压显著降低,而肾素和醛固酮水平显著升高。大多数生理参数和血清电解质水平无显著变化。E/A、E/e'和LAD显著降低,而EF和IVC未观察到显著变化。E/e'在时间、性别和年龄之间的相互作用不显著。
本研究表明,托格列净可改善左心室舒张功能,且不受性别和年龄影响,同时保持IVC、肾功能和电解质平衡。