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Subclinical Changes in Type 2 Diabetes Patients with Heart Failure Stage A and B Treated with Oral Semaglutide

Larissa Dăniluc1,2,3, Adina Braha4,5,6, Oana Elena Sandu1,2,3

  • 1Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.

Medicina (Kaunas, Lithuania)
|April 26, 2025
PubMed

Insights

Oral semaglutide improved subclinical heart failure in type 2 diabetes patients. Better glycemic control and reduced visceral adiposity correlated with improved left ventricular systolic function.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Type 2 diabetes (T2DM) significantly increases heart failure (HF) morbidity and mortality.
  • New drug therapies offer hope, but subclinical cardiac changes in at-risk patients require investigation.

Purpose of the Study:

  • To investigate subclinical cardiac changes in T2DM patients with HF stage A (at risk) and B (pre-HF) treated with oral semaglutide.
  • To identify predictors of changes in left ventricular systolic function.

Main Methods:

  • Prospective, observational, single-center study of 50 T2DM patients.
  • Assessment of spectral Doppler, tissue Doppler, 2D speckle-tracking (2DST), and metabolic parameters at baseline and one-year follow-up.
  • Correlation and linear stepwise regression analyses to identify predictors of global longitudinal strain (GLS) changes.

Main Results:

  • Improved global longitudinal strain (Δ GLS) negatively correlated with improvements in visceral adiposity index (Δ VAI), lipid-active peptide (Δ LAP), fasting plasma glucose (Δ FPG), triglycerides (Δ TG), and triglyceride-glucose index (Δ TyG).
  • A regression model explained 70% of the variance in Δ GLS, with Δ FPG, cardiac-renal risk (Δ CRR), and low-density lipoprotein cholesterol (Δ LDLc) as significant predictors.
  • Oral semaglutide treatment was associated with improvements in these cardiac and metabolic parameters.

Conclusions:

  • Improved subclinical left ventricular systolic dysfunction in T2DM patients is linked to better glycemic control, reduced visceral adiposity, and decreased insulin resistance.
  • Lipid profiling improvements also play a role in mitigating cardiac dysfunction in this population.

Keywords:
GLP-1 receptor agonistsmetabolic controlspeckle-tracking echocardiographyvisceral adiposity

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