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Dapagliflozin Improved Cardiac Function and Structure in Diabetic Patients with Preserved Ejection Fraction: Results

Marcelino Cortés1, Oscar Lorenzo2,3, Jairo Lumpuy-Castillo2,3

  • 1Cardiology Department, Fundación Jiménez Díaz Hospital, 28040 Madrid, Spain.

Journal of Clinical Medicine
|October 28, 2023
PubMed

Insights

Sodium-glucose cotransporter inhibitors (SGLT2i) improve cardiac structure and function in diabetic patients. Dapagliflozin reduced left ventricle mass and improved cardiac strain and relaxation, benefiting heart health.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter inhibitors (SGLT2i) show cardiovascular benefits in diabetes and heart failure (HF).
  • Mechanisms for SGLT2i cardiovascular benefits are unclear, with conflicting data.
  • SGLT2i effects on cardiac structure and function in patients with preserved ejection fraction require further investigation.

Purpose of the Study:

  • To analyze the effect of dapagliflozin on cardiac structure and function.
  • To assess changes in diabetic patients with normal ejection fraction.
  • To investigate potential mechanisms behind SGLT2i cardiovascular benefits.

Main Methods:

  • Prospective study including 31 diabetic patients without prior SGLT2i use.
  • Dapagliflozin treatment initiated, followed for 6 months.
  • Echocardiography (standard, 3D, speckle tracking), ECG, and laboratory analyses performed at baseline and follow-up.

Main Results:

  • A significant reduction in 3D-estimated left ventricle mass (18 g, p=0.028).
  • Improved left ventricle global longitudinal strain (LV-GLS) (0.3, p=0.036) and increased isovolumetric relaxation time (IVRT) (10.5 ms, p=0.05).
  • Decreased plasma levels of creatin-kinase (CK-MB) and atrial natriuretic peptide (ANP).

Conclusions:

  • Dapagliflozin treatment is associated with structural cardiac improvements (reduced myocardial mass).
  • Functional cardiac improvements include enhanced LV-GLS and IVRT in diabetic patients with normal ejection fraction.
  • SGLT2 inhibition demonstrates beneficial effects on cardiac remodeling and function in this population.

Keywords:
biomarkersdapagliflozinechocardiographysodium-glucose cotransporter type 2 inhibitorsspeckle tracking

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