Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) are a novel class of oral hypoglycaemic agents currently used among patients with type 2 diabetes mellitus (T2DM). The effects of SGLT2-i inhibitors on cardiac structure and function are not fully understood. The aim of the present study is to evaluate the echocardiographic changing among patients with well-controlled TDM2 treated with SGLT2-i inhibitors in real-world setting.
Materials and Methods: 35 well-controlled T2DM patients (65± 9 years, 43.7% male) with preserved left ventricular ejection fraction and 35 age and sex-matched controls were included. T2DM patients underwent clinical and laboratory evaluation; 12-lead surface electrocardiogram (ECG); 2-dimensional color Doppler echocardiography at enrolment, before SGLT2-i administration, and at six months follow-up after an uninterrupted 10 mg once daily of Empagliflozin (n: 21) or Dapagliflozin (n: 14). Standard echocardiographic measurements, LV global longitudinal strain (LV-GLS), global wasted work (GWW) and global work efficiency (GWE) were calculated.
Results: T2DM patients showed higher EE’ ratio (8.3± 2.5 vs. 6.3± 0.9; p< 0.0001) and lower LV- GLS (15.8 ± 8.1 vs. 22.1± 1.4%; P<0.0001) and global myocardial work efficiency (91± 4 vs 94± 3%; P: 0.0007) compared to age and sex-matched controls. At six-months follow-up, T2DM patients showed a significant increase in LVEF (58.9± 3.2 vs 62± 3.2; p<0.0001), LV-GLS (16.2± 2.8 vs 18.7± 2.4%; p=0.003) and GWE (90.3± 3.5 vs 93.3± 3.2%; P= 0.0004) values; conversely, GWW values (161.2± 33.6 vs 112.72± 37.3 mmHg%; P<0.0001) significantly decreased.
Conclusions: SGLT2-I therapy showed a significant anti-remodelling effectiveness, improving the LV-GLS and MWE, among well-controlled diabetic patients with preserved left ventricular ejection fraction.