Predictors of Epicardial Fat Volume Decrease after Dapagliflozin Treatment in Patients with Type 2 Diabetes.

Area of Science:

• Cardiology
• Endocrinology
• Medical Imaging

Background:

• Dapagliflozin reduces epicardial fat volume (EFV) in type 2 diabetes (T2D) patients.
• EFV reduction correlates with improved diastolic function but is not routinely assessed due to cost and radiation exposure.
• Identifying predictive biomarkers for EFV reduction is crucial for T2D management.

Purpose of the Study:

• To identify biomarkers that predict EFV reduction in T2D patients treated with dapagliflozin.
• To evaluate the predictive performance of various metabolic and anthropometric indices for EFV changes.

Main Methods:

• Prospective observational study of 52 T2D patients initiated on dapagliflozin 10 mg daily.
• Assessment of EFV, cardiac function, and metabolic parameters via cardiac ultrasonography, CT, elastography, and lab tests at baseline and 6 months.
• Calculation of atherogenic index of plasma (AIP), atherogenic coefficient (AC), triglyceride glucose index (TyG), cardiac risk ratio (CRR), and visceral abdominal index (VAI).

Main Results:

• Higher baseline AIP, CRR, and TyG were associated with greater EFV reduction.
• Lower conicity index, L4 visceral fat volume (L4VFV), left atrium volume, and right ventricle diameter predicted higher EFV reduction.
• TyG (AUROC=0.957), AIP (AUROC=0.903), VAI (AUROC=0.898), and CRR (AUROC=0.772) showed significant predictive performance for EFV reduction.

Conclusions:

• Higher initial EFV predicts greater reduction after 6 months of dapagliflozin treatment in T2D patients.
• The triglyceride glucose index (TyG) demonstrated the highest predictive performance for EFV reduction.
• AIP, CRR, VAI, conicity index, L4VFV, left atrium volume, and right ventricle diameter are valid biomarkers for predicting EFV decrease.