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Background <p>There are insufficient studies to determine whether sodium-glucose cotransporter type 2 inhibitors (SGLT2i) will help reduce early diabetic cardiomyopathy, especially in patients without documented cardiovascular disease.</p> Methods <p>We performed a single center, prospective observation study. A total of 90 patients with type 2 diabetes patients without established heart failure or atherosclerotic cardiovascular disease were enrolled. Echocardiography, cardiac enzyme, and glucose-control data were examined before and 3&#xa0;months after the administration of SGLT2i (dapagliflozin 10&#xa0;mg per day). Cardiovascular risk factors included hypertension, smoking, obesity, dyslipidemia, and old age. The primary end point was the change of E/e’ before and after administration of SGLT2i.</p> Results <p>Most patients (86.7%) had three or more cardiovascular risk factors, and about 32% had all five risk factors. Although the decrease in E/e’ after the administration of SGLT2i was observed in 20% of enrolled patients, there was no significant difference in average E/e’ value or left atrial volume index before and after the SGLT2i medication. Even in patients with all known risk factors including old age, E/e’ value did not decrease after adding SGLT2i (8.9 ± 2.4 vs. 8.7 ± 3.2). There was a statistically significant difference in E/e’ change after the SGLT2i administration between patients younger than 60&#xa0;years and those older than 60&#xa0;years (–0.7 ± 2.2 vs. 1.1 ± 2.8, <i>P</i> = 0.002).</p> Conclusions <p>In type 2 diabetes patients without documented cardiovascular disease including heart failure, administration of SGLT2i showed no improvement in diastolic function profile. Further large-scale randomized studies are needed to determine who will benefit from potential cardiovascular events with early addition of SGLT2i.</p>

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Is early use of sodium-glucose cotransporter type 2 inhibitor (SGLT2i) necessary even in diabetic patients without cardiovascular disease: a prospective study regarding the effect of SGLT2i on left ventricular diastolic function

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  • 发表日期：

    2025年1月13日

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  • Kina Jeon,
  • Shin Yi Jang,
  • You-Bin Lee,
  • Jihoon Kim,
  • Darae Kim,
  • Sung-A Chang,
  • Sung-Ji Park,
  • Sang-Chol Lee,
  • Seung Woo Park,
  • Moon-Kyu Lee,
  • Eun Kyoung Kim,
  • Kyu Yeon Hur

摘要

Background

There are insufficient studies to determine whether sodium-glucose cotransporter type 2 inhibitors (SGLT2i) will help reduce early diabetic cardiomyopathy, especially in patients without documented cardiovascular disease.

Methods

We performed a single center, prospective observation study. A total of 90 patients with type 2 diabetes patients without established heart failure or atherosclerotic cardiovascular disease were enrolled. Echocardiography, cardiac enzyme, and glucose-control data were examined before and 3 months after the administration of SGLT2i (dapagliflozin 10 mg per day). Cardiovascular risk factors included hypertension, smoking, obesity, dyslipidemia, and old age. The primary end point was the change of E/e’ before and after administration of SGLT2i.

Results

Most patients (86.7%) had three or more cardiovascular risk factors, and about 32% had all five risk factors. Although the decrease in E/e’ after the administration of SGLT2i was observed in 20% of enrolled patients, there was no significant difference in average E/e’ value or left atrial volume index before and after the SGLT2i medication. Even in patients with all known risk factors including old age, E/e’ value did not decrease after adding SGLT2i (8.9 ± 2.4 vs. 8.7 ± 3.2). There was a statistically significant difference in E/e’ change after the SGLT2i administration between patients younger than 60 years and those older than 60 years (–0.7 ± 2.2 vs. 1.1 ± 2.8, P = 0.002).

Conclusions

In type 2 diabetes patients without documented cardiovascular disease including heart failure, administration of SGLT2i showed no improvement in diastolic function profile. Further large-scale randomized studies are needed to determine who will benefit from potential cardiovascular events with early addition of SGLT2i.