为期3个月的达帕格列净对未经治疗的2型糖尿病患者左心房功能的影响：使用四维超声心动图进行评估

IF 2.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology Pub Date : 2025-03-01 DOI:10.1016/j.hjc.2023.12.002

Miao Zhang , Lanlan Sun , Xiaopeng Wu , Yunyun Qin , Mingming Lin , Xueyan Ding , Weiwei Zhu , Zhe Jiang , Shan Jin , Chenlei Leng , Jiangtao Wang , Xiuzhang Lv , Qizhe Cai

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引用次数: 0

摘要

钠-葡萄糖转运蛋白-2 (SGLT-2)抑制剂达格列净可以改善2型糖尿病(T2DM)患者的左心室功能。然而，对treatment-naïve T2DM患者左心房(LA)功能的影响尚不清楚。本研究的目的是:1)利用4维自动LA定量(4D Auto LAQ)研究达格列净治疗3个月对treatment-naïve T2DM患者LA功能的影响;2)探索临床和LA超声心动图变量变化的关联协变模式。方法采用4d Auto LAQ对treatment-naïve T2DM患者在基线、随访和健康对照(HC)时的LA体积、纵向和周向菌株进行评价。进行稀疏典型相关分析(sCCA)，以捕获treatment-naïve T2DM患者组中临床和LA超声心动图变量变化之间的关联协变模式。结果本研究最终纳入61例treatment-naïve无心血管疾病的T2DM患者和39例健康对照(HC)。Treatment-naïve T2DM患者与HC相比，在基线时LA储层和导管功能降低，与年龄、性别、BMI和血压无关(LASr: 21.11±5.39 vs. 27.08±5.31%，p校正= 0.017;LAScd: -11.51±4.48 vs. -16.74±4.51%，p校正= 0.013)。经达格列净治疗3个月后，T2DM患者的LA储层和导管功能显著改善，不受BMI和血压变化的影响(LASr: 21.11±5.39 vs. 23.84±5.74%，padjusted <0.001;LAScd: -11.51±4.48 vs -12.75±4.70%，调整后<0.001)。临床和LA超声心动图参数呈显著共变(r = 0.562, p = 0.039)。在临床数据集中，心率、胰岛素和BMI的变化与LA超声心动图变量最相关。在LA超声心动图数据集中，LAScd、LASr和LASr_c的变化与临床变量最相关。结论与HC相比，treatment-naïve T2DM患者LA功能较低，这些患者受益于达格列净，尤其是LA功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Effects of 3-month dapagliflozin on left atrial function in treatment-naïve patients with type 2 diabetes mellitus: Assessment using 4-dimensional echocardiography

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Effects of 3-month dapagliflozin on left atrial function in treatment-naïve patients with type 2 diabetes mellitus: Assessment using 4-dimensional echocardiography

Background

The sodium-glucose transporter-2 (SGLT-2) inhibitor dapagliflozin can improve left ventricular (LV) performance in patients with type 2 diabetes mellitus (T2DM). However, the effects on left atrial (LA) function in treatment-naïve T2DM patients remain unclear. The aim of our study was 1) to investigate the effects of 3-month treatment with dapagliflozin on LA function in treatment-naïve patients with T2DM using 4-dimensional automated LA quantification (4D Auto LAQ) and 2) to explore linked covariation patterns of changes in clinical and LA echocardiographic variables.

Methods

4D Auto LAQ was used to evaluate LA volumes, longitudinal and circumferential strains in treatment-naïve T2DM patients at baseline, at follow-up, and in healthy control (HC). Sparse canonical correlation analysis (sCCA) was performed to capture the linked covariation patterns between changes in clinical and LA echocardiographic variables within the treatment-naïve T2DM patient group.

Results

This study finally included 61 treatment-naïve patients with T2DM without cardiovascular disease and 39 healthy controls (HC). Treatment-naïve T2DM patients showed reduced LA reservoir and conduit function at baseline compared to HC, independent of age, sex, BMI, and blood pressure (LASr: 21.11 ± 5.39 vs. 27.08 ± 5.31 %, p_adjusted = 0.017; LAScd: −11.51 ± 4.48 vs. −16.74 ± 4.51 %, p_adjusted = 0.013). After 3-month treatment with dapagliflozin, T2DM patients had significant improvements in LA reservoir and conduit function independent of BMI and blood pressure changes (LASr: 21.11 ± 5.39 vs. 23.84 ± 5.74 %, p_adjusted < 0.001; LAScd: −11.51 ± 4.48 vs. −12.75 ± 4.70 %, p_adjusted < 0.001). The clinical and LA echocardiographic parameters showed significant covariation (r = 0.562, p = 0.039). In the clinical dataset, changes in heart rate, insulin, and BMI were most associated with the LA echocardiographic variate. In the LA echocardiographic dataset, changes in LAScd, LASr, and LASr_c were most associated with the clinical variate.

Conclusion

Compared with HC, treatment-naïve patients with T2DM had lower LA function, and these patients benefited from dapagliflozin administration, particularly in LA function.

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来源期刊

Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

7.30%

发文量

审稿时长

56 days

期刊介绍： The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.