Relationship between saxagliptin use and left ventricular diastolic function assessed by cardiac MRI

Area of Science:

• Cardiology
• Diabetology
• Medical Imaging

Background:

• Type 2 diabetes mellitus (T2DM) is linked to increased cardiovascular event risk.
• The SAVOR-TIMI53 trial noted excess heart failure hospitalizations with saxagliptin in T2DM patients.
• The underlying mechanisms for this excess risk remain unclear.

Purpose of the Study:

• To investigate the impact of saxagliptin on left ventricular (LV) diastolic function.
• To assess subclinical changes using cardiac magnetic resonance imaging (CMR) over six months.
• To evaluate diastolic parameters in T2DM patients without pre-existing heart failure.

Main Methods:

• Prospective study of 16 T2DM patients without heart failure.
• Cardiac MRI (CMR) performed at baseline and after 6 months of saxagliptin treatment.
• Assessment of LV diastolic function via peak filling rate (PFR/LVEDV), time to peak filling (TPF/RR), and early diastolic strain rate (GLSR-E, GCSR-E) using feature tracking (FT-CMR).

Main Results:

• No significant changes were observed in mean PFR over 6 months (p=0.86).
• Other assessed diastolic parameters, including PFR/EDV, TPF, TPF/RR, GLSR-E, and GCSR-E, also showed no significant alterations (all p>0.50).
• The study included patients with mean age 59.9 years, 69% males, HbA1c 8.3%, and LVEF 57%.

Conclusions:

• Six months of saxagliptin treatment did not induce significant subclinical changes in LV diastolic function.
• CMR assessment did not reveal adverse effects on diastolic function in T2DM patients without heart failure.
• Further research may be needed to fully understand saxagliptin's cardiovascular effects in T2DM.