Improvements of myocardial strain and work in diabetes patients with normal ejection fraction after empagliflozin treatment,Journal of Diabetes Investigation

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Improvements of myocardial strain and work in diabetes patients with normal ejection fraction after empagliflozin treatment
Journal of Diabetes Investigation ( IF 3.1 ) Pub Date : 2024-03-27 , DOI: 10.1111/jdi.14199
Xueqing Cheng ₁ , Peina Huang ₁ , Hongyun Liu ₁ , Xiaojun Bi ₁ , Yiping Gao ₁ , Ruirui Lu ₁ , Yipeng Gao ₁ , Yani Liu ₁ , Youbin Deng ₁

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Aims/IntroductionTo assess the effect of empagliflozin treatment on left ventricular (LV), right ventricular (RV) and left atrial (LA) functions in diabetes patients with normal ejection fraction.Materials and MethodsThe study included a total of 128 diabetes patients with multiple cardiovascular risk factors who were subjected to a 6‐month follow up from the initiation of empagliflozin treatment. Before and after treatment with empagliflozin, LV, RV and LA strain, and noninvasive myocardial work parameters were evaluated by speckle tracking echocardiography.ResultsIn 128 diabetes patients (mean age 56 ± 8 years, 85 men) with multiple cardiovascular risk factors, myocardial strain and work parameters were impaired, despite the absence of significant clinical symptoms of heart failure. After 6‐month treatment with empagliflozin, the absolute value of LV strain in all directions increased, represented by LV global longitudinal strain (−18.0 ± 1.7% to −19.2 ± 1.7% [mean ± SD]). The same trend in LV global work efficiency (93 [91–94] % to 94 [93–95] % [median (IQR)]), RV free‐wall longitudinal strain (−24.0 ± 2.7% to −25.0 ± 2.8%), LA reservoir (31 ± 5% to 34 ± 5%) and conduit strain (−14 ± 4% to −16 ± 4%) was also observed. LV mass index (106.9 ± 16.8–103.6 ± 16.4 g/m2) and LV global wasted work (143 [111–185] mmHg% to 108 [88–141] mmHg%) decreased after treatment (P < 0.05 for all). LV volume and LA volume index remained unchanged after treatment. In the multivariable analysis, the change in LA reservoir strain (β = 0.050, P = 0.035) and baseline global longitudinal strain (β = −0.488, P < 0.001) were independent predictors of improvement in LV global longitudinal strain.ConclusionsThis study suggests that 6‐month treatment with empagliflozin improved LV, RV and LA functions in diabetes patients with normal ejection fraction.

中文翻译：

射血分数正常的糖尿病患者恩格列净治疗后心肌应变和工作的改善

目的/简介评估恩格列净治疗对射血分数正常的糖尿病患者左心室（LV）、右心室（RV）和左心房（LA）功能的影响。材料和方法该研究共纳入 128 名患有多发性心血管疾病的糖尿病患者。从恩格列净治疗开始后接受 6 个月随访的危险因素。通过斑点追踪超声心动图评估恩格列净治疗前后的 LV、RV 和 LA 应变以及无创心肌做功参数。结果在 128 名糖尿病患者（平均年龄 56 ± 8 岁，85 名男性）中，有多种心血管危险因素、心肌应变和尽管没有明显的心力衰竭临床症状，但工作参数仍受到损害。恩格列净治疗 6 个月后，左心室各个方向应变的绝对值均增加，以左室整体纵向应变表示（-18.0 ± 1.7% 至 -19.2 ± 1.7% [平均值 ± 标准差]）。左心室整体工作效率（93 [91–94] % 至 94 [93–95] % [中位数 (IQR)]）、右心室自由壁纵向应变（−24.0 ± 2.7% 至 -25.0 ± 2.8%）具有相同的趋势）、LA 储层（31 ± 5% 至 34 ± 5%）和导管应变（-14 ± 4% 至 -16 ± 4%）也被观察到。左心室质量指数 (106.9 ± 16.8–103.6 ± 16.4 g/m 2 ）和左心室总体无用功（143 [111–185] mmHg% 降至 108 [88–141] mmHg%）在治疗后减少（磷全部 < 0.05）。治疗后左心室体积和左心室体积指数保持不变。在多变量分析中，LA 储层应变的变化（ β = 0.050,磷= 0.035) 和基线全局纵向应变 ( β = -0.488，磷< 0。001）是左心室整体纵向应变改善的独立预测因素。结论本研究表明，6个月的恩格列净治疗可改善射血分数正常的糖尿病患者的左心室、右心室和左心室功能。

更新日期：2024-03-27

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