Effect of Empagliflozin and Dapagliflozin on Ambulatory Arterial Stiffness in Patients with Type 2 Diabetes Mellitus and Cardiovascular Co-Morbidities: A Prospective, Observational Study

Patoulias, Dimitrios; Papadopoulos, Christodoulos; Zografou, Ioanna; Katsimardou, Alexandra; Karagiannis, Asterios; Doumas, Michael

doi:10.3390/medicina58091167

Cited by 4 publications

(1 citation statement)

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“…Previous observations in mice models of advanced macrovascular disease have claimed that treatment with the GLP-1R agonist liraglutide conferred attenuation of atherosclerosis and plaque stabilization as well as reduced vascular inflammation and oxidative stress [ 33 , 34 , 35 ]. Contemporary investigation supports the potential for liraglutide and empagliflozin to attenuate cardiac fibrosis in multiple pathological settings identified in both diabetic and nondiabetic states and scrutinize the molecular mechanisms associated with these effects [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Liraglutide, Empagliflozin and Their Combination on Left Atrial Strain and Arterial Function

Katogiannis,

Thymis,

Kousathana

et al. 2024

Medicina

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Background and Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are cardioprotective drugs. We investigated their effects on left atrial function, a major determinant of cardiac diastolic dysfunction in type 2 diabetes mellitus. We also explored the association of changes in arterial stiffness with those of the LA strain after treatment. Materials and Methods: A total of 200 patients (59.5 ± 9.1 year old, 151 male) with type 2 diabetes mellitus treated with metformin were randomized to insulin (n = 50 served as controls), liraglutide (n = 50), empagliflozin (n = 50) or their combination (liraglutide + empagliflozin) (n = 50). We measured at baseline and 6 months post-treatment: (a) left atrial and global left ventricular longitudinal strain by speckle tracking echocardiography; (b) pulse wave velocity (PWV) and central systolic blood pressure. Results: At baseline, there was a correlation of the LA reservoir strain with PWV (r = −0.209, p = 0.008), central SBP (r = −0.151, p = 0.030), EF (r = 0.214, p = 0.004) and GLS (r = −0.279, p = 0.009). The LA reservoir change 6 months post-treatment was correlated with the PWV change in all groups (r = −0.242, p = 0.028). The LA reservoir change 6 months post-treatment was correlated with the GLS change in all groups (r = −0.322, p = 0.004). Six months after intervention, patients treated with liraglutide, empagliflozin and their combination improved the left atrial reservoir strain (GLP1RA 30.7 ± 9.3 vs. 33.9 ± 9.7%, p = 0.011, SGLT2i 30 ± 8.3 vs. 32.3 ± 7.3%, p = 0.04, GLP1&SGLT2i 29.1 ± 8.7 vs. 31.3 ± 8.2, p = 0.007) compared to those treated with insulin (33 ± 8.3% vs. 32.8 ± 7.4, p = 0.829). Also, patients treated with liraglutide and the combination liraglutide and empagliflozin had improved left atrial conduction strain (p < 0.05). Empagliflozin or the combination liraglutide and empagliflozin showed a greater decrease of PWV and central and brachial systolic blood pressure than insulin or GLP-1RA. (p < 0.05). Conclusions: Impaired aortic elastic properties are associated with a decreased LA strain in type 2 diabetics. Treatment with liraglutide, empagliflozin and their combination for 6 months showed a greater improvement of left atrial function compared to insulin treatment in parallel with the improvement of arterial and myocardial functions.

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