Department of Medical Ultrasound, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
J Diabetes Investig. 2024 Jul;15(7):851-860. doi: 10.1111/jdi.14199. Epub 2024 Mar 27.
AIMS/INTRODUCTION: To assess the effect of empagliflozin treatment on left ventricular (LV), right ventricular (RV) and left atrial (LA) functions in diabetes patients with normal ejection fraction.
The study included a total of 128 diabetes patients with multiple cardiovascular risk factors who were subjected to a 6-month follow up from the initiation of empagliflozin treatment. Before and after treatment with empagliflozin, LV, RV and LA strain, and noninvasive myocardial work parameters were evaluated by speckle tracking echocardiography.
In 128 diabetes patients (mean age 56 ± 8 years, 85 men) with multiple cardiovascular risk factors, myocardial strain and work parameters were impaired, despite the absence of significant clinical symptoms of heart failure. After 6-month treatment with empagliflozin, the absolute value of LV strain in all directions increased, represented by LV global longitudinal strain (-18.0 ± 1.7% to -19.2 ± 1.7% [mean ± SD]). The same trend in LV global work efficiency (93 [91-94] % to 94 [93-95] % [median (IQR)]), RV free-wall longitudinal strain (-24.0 ± 2.7% to -25.0 ± 2.8%), LA reservoir (31 ± 5% to 34 ± 5%) and conduit strain (-14 ± 4% to -16 ± 4%) was also observed. LV mass index (106.9 ± 16.8-103.6 ± 16.4 g/m) and LV global wasted work (143 [111-185] mmHg% to 108 [88-141] mmHg%) decreased after treatment (P < 0.05 for all). LV volume and LA volume index remained unchanged after treatment. In the multivariable analysis, the change in LA reservoir strain (β = 0.050, P = 0.035) and baseline global longitudinal strain (β = -0.488, P < 0.001) were independent predictors of improvement in LV global longitudinal strain.
This study suggests that 6-month treatment with empagliflozin improved LV, RV and LA functions in diabetes patients with normal ejection fraction.
目的/引言：评估恩格列净治疗对射血分数正常的糖尿病患者左心室（LV）、右心室（RV）和左心房（LA）功能的影响。
这项研究共纳入 128 例患有多种心血管危险因素的糖尿病患者，他们在接受恩格列净治疗后进行了 6 个月的随访。在开始恩格列净治疗前后，通过斑点追踪超声心动图评估 LV、RV 和 LA 应变以及无创心肌做功参数。
在 128 例（平均年龄 56 ± 8 岁，85 例男性）患有多种心血管危险因素的糖尿病患者中，尽管没有明显的心衰临床症状，但心肌应变和做功参数仍受损。在接受恩格列净治疗 6 个月后，所有方向的 LV 应变绝对值增加，表现为 LV 整体纵向应变（-18.0 ± 1.7%至-19.2 ± 1.7%[均值 ± 标准差]）。LV 整体工作效率（93[91-94]%至 94[93-95]%[中位数（IQR）]）、RV 游离壁纵向应变（-24.0 ± 2.7%至-25.0 ± 2.8%）、LA 储存（31 ± 5%至 34 ± 5%）和管腔应变（-14 ± 4%至-16 ± 4%）也呈现出相同的趋势。治疗后 LV 质量指数（106.9 ± 16.8-103.6 ± 16.4 g/m）和 LV 整体无用功（143[111-185]mmHg%至 108[88-141]mmHg%）降低（所有 P 值均<0.05）。治疗后 LV 容积和 LA 容积指数无变化。多变量分析显示，LA 储存应变的变化（β=0.050，P=0.035）和基线整体纵向应变（β=-0.488，P<0.001）是 LV 整体纵向应变改善的独立预测因素。
这项研究表明，恩格列净治疗 6 个月可改善射血分数正常的糖尿病患者的 LV、RV 和 LA 功能。
