Effect of Empagliflozin on Cardiac Function, Adiposity, and Diffuse Fibrosis in Patients with Type 2 Diabetes Mellitus

Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, significantly improves cardiovascular outcomes in diabetic patients; however, the mechanism is unclear. We hypothesized that empagliflozin might have beneficial effects on cardiac function, structure, adiposity, and myocardial diffus...

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Bibliographic Details
Published in:Scientific reports 2019-10, Vol.9 (1), p.15348-9, Article 15348
Main Authors: Hsu, Jung-Chi, Wang, Chih-Yuan, Su, Mao-Yuan M., Lin, Lian-Yu, Yang, Wei-Shiung
Format: Article
Language:English
Subjects:
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692/4019/592/75/74
Adipose tissue
Adiposity - drug effects
Benzhydryl Compounds - therapeutic use
Blood pressure
Cardiac function
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - physiopathology
Female
Fibrosis
Glucosides - therapeutic use
Health risk assessment
Heart
Heart Function Tests - drug effects
Heart Ventricles - drug effects
Heart Ventricles - pathology
Heart Ventricles - physiopathology
Humanities and Social Sciences
Humans
Linear Models
Magnetic resonance imaging
Male
Middle Aged
multidisciplinary
Multivariate Analysis
Myocardium - metabolism
Na+/glucose cotransporter
NMR
Nuclear magnetic resonance
Patients
Regression analysis
Science
Science (multidisciplinary)
Sodium
Structure-function relationships
Triglycerides - metabolism
Ventricle
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Summary:Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, significantly improves cardiovascular outcomes in diabetic patients; however, the mechanism is unclear. We hypothesized that empagliflozin might have beneficial effects on cardiac function, structure, adiposity, and myocardial diffuse fibrosis. This prospective study enrolled 35 patients (48.6% men, age 63.5 ± 9.7 years) with type 2 diabetes mellitus (T2DM) from June 1, 2017, to November 31, 2018. The patients received an SGLT2 inhibitor (empagliflozin 25 or 12.5 mg/d) for 6 months in addition to stable oral hypoglycaemic treatment. All patients underwent cardiac magnetic resonance imaging (CMRI) before and after empagliflozin treatment. Left ventricular (LV) function and structure were quantified using cine CMRI. Cardiac adiposity was defined based on pericardial fat and intracardiac triglyceride contents, whereas myocardial diffuse fibrosis was indicated by extracellular volume (ECV). The statistical significance of parameter changes was assessed using paired t-test and stepwise multiple linear regression. There were no significant differences in LV function and structure changes. Cardiac adiposity and diffuse fibrosis indices were also not different before and after empagliflozin treatment. Concerning clinical parameters, only a significant decrease in systolic blood pressure (by 6.4 mmHg) was observed (p = 0.013). Stepwise multiple linear regression revealed that worse baseline MRI parameters were associated with better improvements. Intracardiac triglyceride content decrease was inversely associated with baseline intracardiac triglyceride content (p 
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-019-51949-5