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Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial
BACKGROUND: Liraglutide is an antidiabetic agent with cardioprotective effect. The purpose of this study is to test efficacy of liraglutide to improve diabetic cardiomyopathy in patients with diabetes mellitus type 2 (DM2) without cardiovascular disease. METHODS: Patients with DM2 were randomly assi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492440/ https://www.ncbi.nlm.nih.gov/pubmed/31039778 http://dx.doi.org/10.1186/s12933-019-0857-6 |
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author | Bizino, Maurice B. Jazet, Ingrid M. Westenberg, Jos J. M. van Eyk, Huub J. Paiman, Elisabeth H. M. Smit, Jan W. A. Lamb, Hildebrandus J. |
author_facet | Bizino, Maurice B. Jazet, Ingrid M. Westenberg, Jos J. M. van Eyk, Huub J. Paiman, Elisabeth H. M. Smit, Jan W. A. Lamb, Hildebrandus J. |
author_sort | Bizino, Maurice B. |
collection | PubMed |
description | BACKGROUND: Liraglutide is an antidiabetic agent with cardioprotective effect. The purpose of this study is to test efficacy of liraglutide to improve diabetic cardiomyopathy in patients with diabetes mellitus type 2 (DM2) without cardiovascular disease. METHODS: Patients with DM2 were randomly assigned to receive liraglutide 1.8 mg/day or placebo in this double-blind trial of 26 weeks. Primary outcome measures were LV diastolic function (early (E) and late (A) transmitral peak flow rate, E/A ratio, early deceleration peak (Edec), early peak mitral annular septal tissue velocity (Ea) and estimated LV filling pressure (E/Ea), and systolic function (stroke volume, ejection fraction, cardiac output, cardiac index and peak ejection rate) assessed with CMR. Intention-to-treat analysis of between-group differences was performed using ANCOVA. Mean estimated treatment differences (95% confidence intervals) are reported. RESULTS: 23 patients were randomized to liraglutide and 26 to placebo. As compared with placebo, liraglutide significantly reduced E (− 56 mL/s (− 91 to − 21)), E/A ratio (− 0.17 (− 0.27 to − 0.06)), Edec (− 0.9 mL/s(2) * 10(−3) (− 1.3 to − 0.2)) and E/Ea (− 1.8 (− 3.0 to − 0.6)), without affecting A (3 mL/s (− 35 to 41)) and Ea (0.4 cm/s (− 0.9 to 1.4)). Liraglutide reduced stroke volume (− 9 mL (− 16 to − 2)) and ejection fraction (− 3% (− 6 to − 0.1)), but did not change cardiac output (− 0.4 L/min (− 0.9 to 0.2)), cardiac index (− 0.1 L/min/m(2) (− 0.4 to 0.1)) and peak ejection rate (− 46 mL/s (− 95 to 3)). CONCLUSIONS: Liraglutide reduced early LV diastolic filling and LV filling pressure, thereby unloading the left ventricle. LV systolic function reduced and remained within normal range. Future studies are needed to investigate if liraglutide-induced left ventricular unloading slows progression of diabetic cardiomyopathy into symptomatic stages. Trial registration ClinicalTrials.gov: NCT01761318. |
format | Online Article Text |
id | pubmed-6492440 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64924402019-05-08 Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial Bizino, Maurice B. Jazet, Ingrid M. Westenberg, Jos J. M. van Eyk, Huub J. Paiman, Elisabeth H. M. Smit, Jan W. A. Lamb, Hildebrandus J. Cardiovasc Diabetol Original Investigation BACKGROUND: Liraglutide is an antidiabetic agent with cardioprotective effect. The purpose of this study is to test efficacy of liraglutide to improve diabetic cardiomyopathy in patients with diabetes mellitus type 2 (DM2) without cardiovascular disease. METHODS: Patients with DM2 were randomly assigned to receive liraglutide 1.8 mg/day or placebo in this double-blind trial of 26 weeks. Primary outcome measures were LV diastolic function (early (E) and late (A) transmitral peak flow rate, E/A ratio, early deceleration peak (Edec), early peak mitral annular septal tissue velocity (Ea) and estimated LV filling pressure (E/Ea), and systolic function (stroke volume, ejection fraction, cardiac output, cardiac index and peak ejection rate) assessed with CMR. Intention-to-treat analysis of between-group differences was performed using ANCOVA. Mean estimated treatment differences (95% confidence intervals) are reported. RESULTS: 23 patients were randomized to liraglutide and 26 to placebo. As compared with placebo, liraglutide significantly reduced E (− 56 mL/s (− 91 to − 21)), E/A ratio (− 0.17 (− 0.27 to − 0.06)), Edec (− 0.9 mL/s(2) * 10(−3) (− 1.3 to − 0.2)) and E/Ea (− 1.8 (− 3.0 to − 0.6)), without affecting A (3 mL/s (− 35 to 41)) and Ea (0.4 cm/s (− 0.9 to 1.4)). Liraglutide reduced stroke volume (− 9 mL (− 16 to − 2)) and ejection fraction (− 3% (− 6 to − 0.1)), but did not change cardiac output (− 0.4 L/min (− 0.9 to 0.2)), cardiac index (− 0.1 L/min/m(2) (− 0.4 to 0.1)) and peak ejection rate (− 46 mL/s (− 95 to 3)). CONCLUSIONS: Liraglutide reduced early LV diastolic filling and LV filling pressure, thereby unloading the left ventricle. LV systolic function reduced and remained within normal range. Future studies are needed to investigate if liraglutide-induced left ventricular unloading slows progression of diabetic cardiomyopathy into symptomatic stages. Trial registration ClinicalTrials.gov: NCT01761318. BioMed Central 2019-04-30 /pmc/articles/PMC6492440/ /pubmed/31039778 http://dx.doi.org/10.1186/s12933-019-0857-6 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Investigation Bizino, Maurice B. Jazet, Ingrid M. Westenberg, Jos J. M. van Eyk, Huub J. Paiman, Elisabeth H. M. Smit, Jan W. A. Lamb, Hildebrandus J. Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
title | Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
title_full | Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
title_fullStr | Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
title_full_unstemmed | Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
title_short | Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
title_sort | effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: randomized placebo-controlled trial |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492440/ https://www.ncbi.nlm.nih.gov/pubmed/31039778 http://dx.doi.org/10.1186/s12933-019-0857-6 |
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