Effect of dapagliflozin on cardiac function in people with type 2 diabetes and albuminuria – A double blind randomized placebo-controlled crossover trial

• Published in: Journal of diabetes and its complications Vol. 34; no. 7; p. 107590
• Main Authors: Eickhoff, Mie K., Olsen, Flemming J., Frimodt-Møller, Marie, Diaz, Lars J., Faber, Jens, Jensen, Magnus T., Rossing, Peter, Persson, Frederik
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2020; Elsevier Limited
• Subjects: Albuminuria; Antidiabetics; Biomarkers; Cardiac function; Cardiovascular disease; Diabetes; Double-blind studies; Echocardiography; Ejection fraction; Medical prognosis; Peptides; Pulmonary arteries; SGLT2 inhibitor; Tumor necrosis factor-TNF; Type 2 diabetes; Denmark; Type 2 diabetes; Biomarkers; Cardiovascular disease; Echocardiography; Albuminuria; SGLT2 inhibitor
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2020.107590

Sodium glucose transport inhibitors (SGLT2i) can reduce risk of heart failure (HF) and cardiovascular death in people with type 2 diabetes (T2D) and existing cardiovascular disease. Our aim was to examine the effect of the SGLT2i dapagliflozin on cardiac function in people with T2D and albuminuria.
A secondary analysis of a double-blind, randomized, cross-over study of 12 weeks treatment with dapagliflozin 10 mg versus placebo. Myocardial function was assessed by echocardiography and biomarkers of cardiac risk were measured. An exploratory diastolic composite of echocardiographic variables was computed.
Of the 36 participants completing the study 89% were male, mean age 64 ± 8 years, diabetes duration 16.4 ± 4.7 years and HbA1c 73 ± 15 mmol/mol (8.9 ± 1.4%), 30.6% had former cardiovascular events and 32% had macroalbuminuria. Mean left ventricular ejection fraction (LVEF) was 55.4% after placebo and 54.3% after dapagliflozin (p = 0.15), global longitudinal strain −16.1 vs. −15.9, (p = 0.64), E/e′ 7.6 vs. 7.6 (p = 0.082), and tissue Doppler velocity e′ 10.0 vs. 10.6 (p = 0.05). The composite score showed diastolic function improvement of 19.8% (p = 0.021). No other significant changes were observed.
Dapagliflozin may have minor effects on diastolic function in people with T2D, albuminuria and preserved LVEF.
•Sodium glucose transport inhibitors can reduce risk of heart failure and cardiovascular death in people with type 2 diabetes•The mechanism behind the effect is not clear•We investigated the effect of 12 weeks treatment with dapagliflozin on echocardiography and cardiac markers•No major changes were found, only small changes in diastolic function measures•No changes in NTproBNP, TnI, MRproADM, MRproANP, TNF-α and IL-6