Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure
Sodium–glucose cotransporter-2 inhibitors (SGLT2is) are a relatively new class of antidiabetic drugs that have shown favorable effects in heart failure (HF) patients, irrespective of the left ventricular ejection fraction (LVEF). Recent studies have demonstrated the beneficial effects of empaglifloz...
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MDPI AG
2023-08-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/8/1778 |
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| author | Andrew Xanthopoulos Nikolaos Katsiadas Spyridon Skoularigkis Dimitrios E. Magouliotis Niki Skopeliti Sotirios Patsilinakos Alexandros Briasoulis Filippos Triposkiadis John Skoularigis |
| author_facet | Andrew Xanthopoulos Nikolaos Katsiadas Spyridon Skoularigkis Dimitrios E. Magouliotis Niki Skopeliti Sotirios Patsilinakos Alexandros Briasoulis Filippos Triposkiadis John Skoularigis |
| author_sort | Andrew Xanthopoulos |
| collection | DOAJ |
| description | Sodium–glucose cotransporter-2 inhibitors (SGLT2is) are a relatively new class of antidiabetic drugs that have shown favorable effects in heart failure (HF) patients, irrespective of the left ventricular ejection fraction (LVEF). Recent studies have demonstrated the beneficial effects of empagliflozin on cardiac function and structure; however, less is known about dapagliflozin. The purpose of the current work was to investigate the association between the use of dapagliflozin and cardiac biomarkers as well as the cardiac structure in a cohort of patients with HF and diabetes mellitus (DM). The present work was an observational study that included 118 patients (dapagliflozin group n = 60; control group n = 58) with HF and DM. The inclusion criteria included: age > 18 years, a history of DM and HF, regardless of LVEF, and hospitalization for HF exacerbation within the previous 6 months. The exclusion criteria were previous treatment with SGLT2i or glucagon-like peptide-1 receptor agonists, a GFR< 30 and life expectancy < 1 year. The evaluation of patients (at baseline, 6 and 12 months) included a clinical assessment, laboratory blood tests and echocardiography. The Mann–Whitney test was used for the comparison of continuous variables between the two groups, while Friedman’s analysis of variance for repeated measures was used for the comparison of continuous variables. Troponin (<i>p</i> < 0.001) and brain natriuretic peptide (BNP) (<i>p</i> < 0.001) decreased significantly throughout the follow-up period in the dapagliflozin group, but not in the control group (<i>p</i> > 0.05 for both). The LV end-diastolic volume index (<i>p</i> < 0.001 for both groups) and LV end-systolic volume index (<i>p</i> < 0.001 for both groups) decreased significantly in the dapagliflozin and the control group, respectively. The LVEF increased significantly (<i>p</i> < 0.001) only in the dapagliflozin group, whereas the global longitudinal strain (GLS) improved in the dapagliflozin group (<i>p</i> < 0.001) and was impaired in the control group (<i>p</i> = 0.021). The left atrial volume index decreased in the dapagliflozin group (<i>p</i> < 0.001) but remained unchanged in the control group (<i>p</i> = 0.114). Lastly, the left ventricular mass index increased significantly both in the dapagliflozin (<i>p</i> = 0.003) and control group (<i>p</i> = 0.001). Dapagliflozin, an SGLT2i, was associated with a reduction in cardiac biomarkers and with reverse cardiac remodeling in patients with HF and DM. |
| first_indexed | 2024-03-10T23:47:44Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T23:47:44Z |
| publishDate | 2023-08-01 |
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| record_format | Article |
| series | Life |
| spelling | doaj.art-9b3106a67fce4b96b5e0007406b61de62023-11-19T01:55:34ZengMDPI AGLife2075-17292023-08-01138177810.3390/life13081778Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart FailureAndrew Xanthopoulos0Nikolaos Katsiadas1Spyridon Skoularigkis2Dimitrios E. Magouliotis3Niki Skopeliti4Sotirios Patsilinakos5Alexandros Briasoulis6Filippos Triposkiadis7John Skoularigis8Department of Cardiology, University Hospital of Larissa, 41110 Larissa, GreeceDepartment of Cardiology, Konstantopoulio General Hospital, 14233 Nea Ionia, GreeceDepartment of Cardiology, University Hospital of Larissa, 41110 Larissa, GreeceUnit of Quality Improvement, Department of Cardiothoracic Surgery, University of Thessaly, 41110 Larissa, GreeceDepartment of Cardiology, University Hospital of Larissa, 41110 Larissa, GreeceDepartment of Cardiology, Konstantopoulio General Hospital, 14233 Nea Ionia, GreeceDepartment of Therapeutics, Heart Failure and Cardio-Oncology Clinic, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Cardiology, University Hospital of Larissa, 41110 Larissa, GreeceDepartment of Cardiology, University Hospital of Larissa, 41110 Larissa, GreeceSodium–glucose cotransporter-2 inhibitors (SGLT2is) are a relatively new class of antidiabetic drugs that have shown favorable effects in heart failure (HF) patients, irrespective of the left ventricular ejection fraction (LVEF). Recent studies have demonstrated the beneficial effects of empagliflozin on cardiac function and structure; however, less is known about dapagliflozin. The purpose of the current work was to investigate the association between the use of dapagliflozin and cardiac biomarkers as well as the cardiac structure in a cohort of patients with HF and diabetes mellitus (DM). The present work was an observational study that included 118 patients (dapagliflozin group n = 60; control group n = 58) with HF and DM. The inclusion criteria included: age > 18 years, a history of DM and HF, regardless of LVEF, and hospitalization for HF exacerbation within the previous 6 months. The exclusion criteria were previous treatment with SGLT2i or glucagon-like peptide-1 receptor agonists, a GFR< 30 and life expectancy < 1 year. The evaluation of patients (at baseline, 6 and 12 months) included a clinical assessment, laboratory blood tests and echocardiography. The Mann–Whitney test was used for the comparison of continuous variables between the two groups, while Friedman’s analysis of variance for repeated measures was used for the comparison of continuous variables. Troponin (<i>p</i> < 0.001) and brain natriuretic peptide (BNP) (<i>p</i> < 0.001) decreased significantly throughout the follow-up period in the dapagliflozin group, but not in the control group (<i>p</i> > 0.05 for both). The LV end-diastolic volume index (<i>p</i> < 0.001 for both groups) and LV end-systolic volume index (<i>p</i> < 0.001 for both groups) decreased significantly in the dapagliflozin and the control group, respectively. The LVEF increased significantly (<i>p</i> < 0.001) only in the dapagliflozin group, whereas the global longitudinal strain (GLS) improved in the dapagliflozin group (<i>p</i> < 0.001) and was impaired in the control group (<i>p</i> = 0.021). The left atrial volume index decreased in the dapagliflozin group (<i>p</i> < 0.001) but remained unchanged in the control group (<i>p</i> = 0.114). Lastly, the left ventricular mass index increased significantly both in the dapagliflozin (<i>p</i> = 0.003) and control group (<i>p</i> = 0.001). Dapagliflozin, an SGLT2i, was associated with a reduction in cardiac biomarkers and with reverse cardiac remodeling in patients with HF and DM.https://www.mdpi.com/2075-1729/13/8/1778sodium glucose cotransporter-2 inhibitorsdapagliflozinremodelingdiabetes mellitusheart failure |
| spellingShingle | Andrew Xanthopoulos Nikolaos Katsiadas Spyridon Skoularigkis Dimitrios E. Magouliotis Niki Skopeliti Sotirios Patsilinakos Alexandros Briasoulis Filippos Triposkiadis John Skoularigis Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure Life sodium glucose cotransporter-2 inhibitors dapagliflozin remodeling diabetes mellitus heart failure |
| title | Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure |
| title_full | Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure |
| title_fullStr | Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure |
| title_full_unstemmed | Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure |
| title_short | Association between Dapagliflozin, Cardiac Biomarkers and Cardiac Remodeling in Patients with Diabetes Mellitus and Heart Failure |
| title_sort | association between dapagliflozin cardiac biomarkers and cardiac remodeling in patients with diabetes mellitus and heart failure |
| topic | sodium glucose cotransporter-2 inhibitors dapagliflozin remodeling diabetes mellitus heart failure |
| url | https://www.mdpi.com/2075-1729/13/8/1778 |
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