医学
恩帕吉菲
射血分数
达帕格列嗪
内科学
心脏病学
心力衰竭
糖尿病
2型糖尿病
危险系数
内分泌学
置信区间
作者
Shaimaa B. El-Saied,Wafaa S El-Sherbeny,Sara I. El-sharkawy
标识
DOI:10.1016/j.ijcha.2023.101329
摘要
We aimed to assess the impact of adding sodium glucose co-transporters-2 inhibitors (SGLT-2I) on cardiac remodeling in type 2 diabetic patients with heart failure with mildly reduced ejection fraction (HFmrEF) that had been under-represented in most clinical trials through the analysis of left atrial (LA) phasic functions with 2-D speckle tracking echocardiography (2D- STE We enrolled 70 patients with type 2 diabetes (T2DM) and stable HFmrEF (35 patients received one of SGLT-2I either empagliflozin or dapagliflozin). Laboratory assessment and echocardiographic evaluation were carried out at baseline and after 6 months. LA volumes and deformation analysis were conducted using 2D-STE. Three LA strain parameters were obtained (LA reservoir strain, contractile strain, and conduit strain). After 6 months of SGLT-2 I treatment, there was better control of HbA1C and improvement of diastolic functions (E/e′ ratio and LAV-I significantly decreased. P < 0.001*). LVGLS increased, LA functions and all LA strain curve values improved, LA reservoir increased from 17.3 ± 2.0 to 23.8 ± 3.6, LA conduit from 11.0 ± 2.2 to 13.7 ± 2.8 and LA contractile from 6.5 ± 1.4 to 10.5 ± 2.6, P < 0.001* for all. Changes in LA strain values were significantly associated with the changes in LVGLS, LAEF %, E/ e′ ratio, and LAV-I. Adding SGLT-2I to existing guideline-directed medical therapy in patients with T2DM and HFmrEF is associated with favorable clinical outcomes and significant improvement of LA volume and functions, with further improvement of LV diastolic and longitudinal functions.
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