Xanthopoulos Andrew, Katsiadas Nikolaos, Skoularigkis Spyridon, Magouliotis Dimitrios E, Skopeliti Niki, Patsilinakos Sotirios, Briasoulis Alexandros, Triposkiadis Filippos, Skoularigis John
Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece.
Department of Cardiology, Konstantopoulio General Hospital, 14233 Nea Ionia, Greece.
Life (Basel). 2023 Aug 20;13(8):1778. doi: 10.3390/life13081778.
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are a relatively new class of antidiabetic drugs that have shown favorable effects in heart failure (HF) patients, irrespective of the left ventricular ejection fraction (LVEF). Recent studies have demonstrated the beneficial effects of empagliflozin on cardiac function and structure; however, less is known about dapagliflozin. The purpose of the current work was to investigate the association between the use of dapagliflozin and cardiac biomarkers as well as the cardiac structure in a cohort of patients with HF and diabetes mellitus (DM). The present work was an observational study that included 118 patients (dapagliflozin group n = 60; control group n = 58) with HF and DM. The inclusion criteria included: age > 18 years, a history of DM and HF, regardless of LVEF, and hospitalization for HF exacerbation within the previous 6 months. The exclusion criteria were previous treatment with SGLT2i or glucagon-like peptide-1 receptor agonists, a GFR< 30 and life expectancy < 1 year. The evaluation of patients (at baseline, 6 and 12 months) included a clinical assessment, laboratory blood tests and echocardiography. The Mann-Whitney test was used for the comparison of continuous variables between the two groups, while Friedman's analysis of variance for repeated measures was used for the comparison of continuous variables. Troponin ( < 0.001) and brain natriuretic peptide (BNP) ( < 0.001) decreased significantly throughout the follow-up period in the dapagliflozin group, but not in the control group ( > 0.05 for both). The LV end-diastolic volume index ( < 0.001 for both groups) and LV end-systolic volume index ( < 0.001 for both groups) decreased significantly in the dapagliflozin and the control group, respectively. The LVEF increased significantly ( < 0.001) only in the dapagliflozin group, whereas the global longitudinal strain (GLS) improved in the dapagliflozin group ( < 0.001) and was impaired in the control group ( = 0.021). The left atrial volume index decreased in the dapagliflozin group ( < 0.001) but remained unchanged in the control group ( = 0.114). Lastly, the left ventricular mass index increased significantly both in the dapagliflozin ( = 0.003) and control group ( = 0.001). Dapagliflozin, an SGLT2i, was associated with a reduction in cardiac biomarkers and with reverse cardiac remodeling in patients with HF and DM.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）是一类相对较新的抗糖尿病药物，已在心力衰竭（HF）患者中显示出有益效果，无论左心室射血分数（LVEF）如何。最近的研究表明恩格列净对心脏功能和结构有有益作用；然而，关于达格列净的了解较少。当前研究的目的是调查在一组心力衰竭合并糖尿病（DM）患者中，使用达格列净与心脏生物标志物以及心脏结构之间的关联。本研究为一项观察性研究，纳入了118例心力衰竭合并糖尿病患者（达格列净组n = 60；对照组n = 58）。纳入标准包括：年龄>18岁，有糖尿病和心力衰竭病史，无论LVEF如何，且在过去6个月内因心力衰竭加重住院。排除标准为既往使用过SGLT2i或胰高血糖素样肽-1受体激动剂、肾小球滤过率（GFR）<30以及预期寿命<1年。对患者（基线、6个月和12个月时）的评估包括临床评估、实验室血液检查和超声心动图检查。两组之间连续变量的比较采用Mann-Whitney检验，连续变量的重复测量比较采用Friedman方差分析。在随访期间，达格列净组肌钙蛋白（<0.001）和脑钠肽（BNP）（<0.001）显著下降，而对照组则无下降（两者均>0.05）。达格列净组和对照组的左心室舒张末期容积指数（两组均<0.001）和左心室收缩末期容积指数（两组均<
