Basile Paolo, Guaricci Andrea Igoren, Piazzolla Giuseppina, Volpe Sara, Vozza Alfredo, Benedetto Marina, Carella Maria Cristina, Santoro Daniela, Monitillo Francesco, Baggiano Andrea, Mushtaq Saima, Fusini Laura, Fazzari Fabio, Forleo Cinzia, Ribecco Nunziata, Pontone Gianluca, Sabbà Carlo, Ciccone Marco Matteo
University Cardiology Unit, Interdisciplinary Department of Medicine, Policlinic University Hospital, 70121 Bari, Italy.
Interdisciplinary Department of Medicine, School of Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy.
J Clin Med. 2023 Feb 16;12(4):1586. doi: 10.3390/jcm12041586.
(1) Background: Glucagone-Like Peptide-1 Receptor Agonists (GLP-1 RAs) (GLP-1 RAs) are incretine-based medications recommended in the treatment of type 2 Diabetes Mellitus (DM2) with atherosclerotic cardiovascular disease (ASCVD) or high or very high cardiovascular (CV) risk. However, knowledge of the direct mechanism of GLP-1 RAs on cardiac function is modest and not yet fully elucidated. Left ventricular (LV) Global Longitudinal Strain (GLS) with Speckle Tracking Echocardiography (STE) represents an innovative technique for the evaluation of myocardial contractility. (2) Methods: an observational, perspective, monocentric study was conducted in a cohort of 22 consecutive patients with DM2 and ASCVD or high/very high CV risk, enrolled between December 2019 and March 2020 and treated with GLP-1 RAs dulaglutide or semaglutide. The echocardiographic parameters of diastolic and systolic function were recorded at baseline and after six months of treatment. (3) Results: the mean age of the sample was 65 ± 10 years with a prevalence of the male sex (64%). A significant improvement in the LV GLS (mean difference: -1.4 ± 1.1%; value < 0.001) was observed after six months of treatment with GLP-1 RAs dulaglutide or semaglutide. No relevant changes were seen in the other echocardiographic parameters. (4) Conclusions: six months of treatment with GLP-1 RAs dulaglutide or semaglutide leads to an improvement in the LV GLS in subjects with DM2 with and high/very high risk for ASCVD or with ASCVD. Further studies on larger populations and with a longer follow-up are warranted to confirm these preliminary results.
(1) 背景：胰高血糖素样肽-1受体激动剂（GLP-1 RAs）是用于治疗伴有动脉粥样硬化性心血管疾病（ASCVD）或心血管（CV）风险高或非常高的2型糖尿病（DM2）的基于肠促胰岛素的药物。然而，关于GLP-1 RAs对心脏功能的直接机制的了解有限，尚未完全阐明。采用斑点追踪超声心动图（STE）测量的左心室（LV）整体纵向应变（GLS）是评估心肌收缩力的一种创新技术。(2) 方法：对2019年12月至2020年3月期间连续纳入的22例患有DM2且伴有ASCVD或CV风险高/非常高的患者进行了一项观察性、前瞻性、单中心研究，这些患者接受了GLP-1 RAs度拉糖肽或司美格鲁肽治疗。在基线和治疗6个月后记录舒张和收缩功能的超声心动图参数。(3) 结果：样本的平均年龄为65±10岁，男性患病率为64%。在用度拉糖肽或司美格鲁肽治疗6个月后，观察到LV GLS有显著改善（平均差异：-1.4±1.1%；P值<0.001）。其他超声心动图参数未见相关变化。(4) 结论：用度拉糖肽或司美格鲁肽治疗6个月可使患有DM2且有ASCVD高/非常高风险或患有ASCVD的患者的LV GLS得到改善。有必要对更大规模人群进行进一步研究并进行更长时间的随访，以证实这些初步结果。
