Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
Department of Internal Medicine, University Hospital of Amager, Copenhagen, Denmark.
Cardiovasc Diabetol. 2021 Jan 7;20(1):12. doi: 10.1186/s12933-020-01205-2.
Diastolic dysfunction is highly prevalent in patients with type 2 diabetes mellitus (T2DM) and is associated with overweight, glucose dysregulation and coronary artery disease (CAD). The GLP-1 receptor agonist, liraglutide, has shown to induce weight loss and improve metabolic factors, thus modulating factors associated with diastolic dysfunction. We have previously reported the effects of liraglutide on systolic function, and in this current study we explore the effects of liraglutide on diastolic function parameters in patients with stable CAD, preserved left ventricular ejection fraction (LVEF), and newly diagnosed T2DM.
Thirty subjects were randomized to liraglutide or placebo intervention for 12 + 12-weeks in this double-blind cross-over study. 2D-echocardiography using tissue velocity imaging was used for assessment of diastolic function parameters. Early diastolic filling velocity (E), late atrial filling velocity (A), E-wave deceleration time (EDT) and E/A ratio was assessed from the pulse wave (PW)-Doppler velocity recording of the mitral inflow. Peak early diastolic annular velocities (e') was measured from color tissue doppler images.
Liraglutide, when compared to placebo, induced a significant reduction in average e' and lateral e' velocities (- 0.57 cm/s [- 1.05 to - 0.08] and -0.74 cm/s [-1.32 to -0.15], respectively). Adjusted for the concomitant increase in HR (+ 6.16 bpm [0.79 to 11.54], the changes were not significant. No significant changes in other diastolic function parameters were observed.
Liraglutide therapy did not improve any diastolic function parameters in subjects with T2DM, CAD, and preserved LVEF. Instead, a deterioration in e' was observed, which was associated to an increase in heart rate induced by liraglutide therapy. Trial registration Clinical Trial Registration: http://www.clinicaltrials.gov (unique identifier: NCT01595789) (first submitted May 8, 2012).
2 型糖尿病（T2DM）患者舒张功能障碍发生率较高，与超重、葡萄糖代谢紊乱和冠状动脉疾病（CAD）有关。GLP-1 受体激动剂利拉鲁肽可引起体重减轻和改善代谢因素，从而调节与舒张功能障碍相关的因素。我们之前已经报道了利拉鲁肽对收缩功能的影响，在本研究中，我们探讨了利拉鲁肽对舒张功能参数的影响，对象为稳定 CAD、保留左心室射血分数（LVEF）和新诊断 T2DM 的患者。
30 名患者被随机分为利拉鲁肽或安慰剂组，进行 12+12 周的双盲交叉研究。应用组织速度成像二维超声心动图评估舒张功能参数。从二尖瓣流入道脉冲波（PW）-多谱勒速度记录评估舒张早期充盈速度（E）、晚期心房充盈速度（A）、E 波减速时间（EDT）和 E/A 比值。从彩色组织多谱勒图像测量舒张早期瓣环峰值速度（e'）。
与安慰剂相比，利拉鲁肽可显著降低平均 e'和外侧 e'速度（-0.57cm/s [-1.05 至 -0.08]和 -0.74cm/s [-1.32 至 -0.15]）。调整伴随的 HR 增加（+6.16bpm [0.79 至 11.54]）后，变化无统计学意义。其他舒张功能参数无显著变化。
利拉鲁肽治疗并未改善 T2DM、CAD 和保留 LVEF 患者的任何舒张功能参数。相反，观察到 e'恶化，这与利拉鲁肽治疗引起的心率增加有关。
临床Trials.gov 登记（http://www.clinicaltrials.gov，唯一标识符：NCT01595789）（首次提交于 2012 年 5 月 8 日）。
