BACKGROUND The effect of sodium glucose cotransporter type 2 (SGLT2) inhibitor on left ventricular (LV) longitudinal myocardial function in type 2 diabetes mellitus (T2DM) patients with heart failure (HF) has remained unclear. METHODS We analyzed data from our previous prospective multicenter study, in which we investigated the effect of the SGLT2 inhibitor dapagliflozin on LV diastolic functional parameters of T2DM patients with stable HF at five institutions in Japan. Echocardiography was performed at baseline and 6 months after administration of dapagliflozin. LV diastolic function was defined as the ratio of mitral inflow E to mitral e' annular velocities (E/e'). LV longitudinal myocardial function was assessed as global longitudinal strain (GLS), which in turn was determined as the averaged peak longitudinal strain from standard LV apical views. RESULTS E/e' significantly decreased from 9.3 to 8.5 cm/s 6 months after administration of dapagliflozin (p = 0.020) as previously described, while GLS showed significant improvement from 15.5 ± 3.5% to 16.9 ± 4.1% (p < 0.01) 6 months after administration of dapagliflozin. Furthermore, improvement of GLS in HF with preserved ejection fraction patients was more significant from 17.0 ± 1.9% to 18.7 ± 2.0% (p < 0.001), compared to that in HF with mid-range ejection fraction and HF with reduced ejection fraction patients from 14.4 ± 2.4% to 15.5 ± 1.8% (p = 0.06) and from 8.1 ± 1.5% to 7.8 ± 2.1% (p = 0.44), respectively. It was noteworthy that multiple regression analysis showed that the change in GLS after administration of dapagliflozin was the only independent determinant parameters for the change in E/e' after administration of dapagliflozin. CONCLUSION Dapagliflozin was found to be associated with improvement of LV longitudinal myocardial function, which led to further improvement of LV diastolic function of T2DM patients with stable HF. GLS-guided management may thus lead to improved management of T2DM patients with stable HF.

中文翻译：

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达格列净对慢性心力衰竭2型糖尿病患者左心室纵向功能的积极影响。

背景技术2型葡萄糖共转运蛋白（SGLT2）抑制剂对2型糖尿病（T2DM）心力衰竭（HF）患者的左心室（LV）纵向心肌功能的影响尚不清楚。方法我们分析了先前的前瞻性多中心研究中的数据，其中我们在日本的5家机构中研究了SGLT2抑制剂dapagliflozin对稳定型HF的T2DM患者的LV舒张功能参数的影响。给予dapagliflozin的基线和6个月后进行超声心动图检查。左心室舒张功能定义为二尖瓣流入量E与二尖瓣e'环形速度（E / e'）之比。LV纵向心肌功能被评估为整体纵向应变（GLS），从标准LV根尖视图中将其确定为平均峰值纵向应变。结果如前所述，达格列净治疗后6个月E / e'从9.3 cm / s显着下降（p = 0.020），而GLS显示从15.5±3.5％显着改善至16.9±4.1％（p <0.01）6达格列净给药后数月。此外，与射血分数保留的HF患者相比，射血分数保留的HF患者的GLS改善从17.0±1.9％增至18.7±2.0％（p <0.001）更为显着。 14.4±2.4％至15.5±1.8％（p = 0.06）和8.1±1.5％至7.8±2.1％（p = 0.44）。值得注意的是，多元回归分析表明，达格列净给药后GLS的变化是达格列净给药后E / e'变化的唯一独立决定因素。结论发现达格列净与左心室纵向心肌功能改善有关，从而进一步改善了心衰稳定的T2DM患者的左心室舒张功能。因此，GLS指导的治疗可能会改善HF稳定的T2DM患者的治疗。