Dapagliflozin improves Myocardial Flow Reserve in patients with Type 2 Diabetes: the DAPAHEART Trial

نویسندگان

چکیده

Abstract Objective Cardiovascular (CV) outcome trials have shown that in patients with type 2 diabetes (T2D), treatment sodium-glucose cotransporter-2 inhibitors (SGLT-2i) reduces CV mortality and admission rates for heart failure (HF). However, the mechanisms behind these benefits are not fully understood. This study was performed to investigate effects of SGLT-2i dapagliflozin on whole body insulin sensitivity, myocardial perfusion, metabolism T2D without HF. Research design methods a single-center, prospective, randomized, double-blind controlled clinical trial including 16 randomized (10 mg) or placebo. Whole glucose uptake (WBGU) (MGU) were measured PET/CT FDG during euglycemic hyperinsulinemic clamp. Stress (i.v. adenosine infusion) resting blood flow (MBF) reserve (MFR) calculated by 13N-ammonia. Results (8 dapagliflozin; 8 placebo). The groups well-matched baseline characteristics (age, duration, HbA1c, renal function). Dapagliflozin significantly improved MFR (2.56±0.26 vs 3.59±0.35) compared placebo group (2.34±0.21 2.38±0.24; p interaction =0.001) associated reduction MBF corrected cardiac workload (p=0.045). A trend toward an increase stress also detected (p=0.058). Moreover, we observed WBGU borderline statistical significance (p=0.06) no MGU (p=0.41). Conclusions At best our knowledge, study, first time, demonstrated SGLT-2 inhibition increases patients. data presented provide new potential explanation cardiovascular as they make more tolerant detrimental impact obstructive coronary atherosclerosis MFR. Funding Acknowledgement Type funding sources: None.

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ژورنال

عنوان ژورنال: European Heart Journal

سال: 2022

ISSN: ['2634-3916']

DOI: https://doi.org/10.1093/eurheartj/ehac544.2662