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Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure

BACKGROUND: Sodium‐glucose cotransporter 2 inhibitors improve cardiovascular outcomes in patients with diabetes with and without heart failure (HF). However, their influence on sympathetic nerve activity (SNA) remains unclear. The purpose of this study was to evaluate the effect of sodium‐glucose co...

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Autores principales: Hamaoka, Takuto, Murai, Hisayoshi, Hirai, Tadayuki, Sugimoto, Hiroyuki, Mukai, Yusuke, Inoue, Oto, Takashima, Shinichiro, Kato, Takeshi, Takata, Shigeo, Usui, Soichiro, Sakata, Kenji, Kawashiri, Masa‐Aki, Takamura, Masayuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751957/
https://www.ncbi.nlm.nih.gov/pubmed/34719241
http://dx.doi.org/10.1161/JAHA.121.022637
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author Hamaoka, Takuto
Murai, Hisayoshi
Hirai, Tadayuki
Sugimoto, Hiroyuki
Mukai, Yusuke
Inoue, Oto
Takashima, Shinichiro
Kato, Takeshi
Takata, Shigeo
Usui, Soichiro
Sakata, Kenji
Kawashiri, Masa‐Aki
Takamura, Masayuki
author_facet Hamaoka, Takuto
Murai, Hisayoshi
Hirai, Tadayuki
Sugimoto, Hiroyuki
Mukai, Yusuke
Inoue, Oto
Takashima, Shinichiro
Kato, Takeshi
Takata, Shigeo
Usui, Soichiro
Sakata, Kenji
Kawashiri, Masa‐Aki
Takamura, Masayuki
author_sort Hamaoka, Takuto
collection PubMed
description BACKGROUND: Sodium‐glucose cotransporter 2 inhibitors improve cardiovascular outcomes in patients with diabetes with and without heart failure (HF). However, their influence on sympathetic nerve activity (SNA) remains unclear. The purpose of this study was to evaluate the effect of sodium‐glucose cotransporter 2 inhibitors on SNA and compare the responses of SNA to sodium‐glucose cotransporter 2 inhibitors in patients with type 2 diabetes with and without HF. METHODS AND RESULTS: Eighteen patients with type 2 diabetes, 10 with HF (65.4±3.68 years) and 8 without HF (63.3±3.62 years), were included. Muscle SNA (MSNA), heart rate, and blood pressure were recorded before and 12 weeks after administration of dapagliflozin (5 mg/day). Sympathetic and cardiovagal baroreflex sensitivity were simultaneously calculated. Brain natriuretic peptide level increased significantly at baseline in patients with HF than those without HF, while MSNA, blood pressure, and hemoglobin A1c did not differ between the 2 groups. Fasting blood glucose and homeostatic model assessment of insulin resistance did not change in either group after administering dapagliflozin. MSNA decreased significantly in both groups. However, the reduction in MSNA was significantly higher in patients with HF than patients with non‐HF (−20.2±3.46 versus −9.38±3.65 bursts/100 heartbeats; P=0.049), which was concordant with the decrease in brain natriuretic peptide. CONCLUSIONS: Dapagliflozin significantly decreased MSNA in patients with type 2 diabetes regardless of its blood glucose‐lowering effect. Moreover, the reduction in MSNA was more prominent in patients with HF than in patients with non‐HF. These results indicate that the cardioprotective effects of sodium‐glucose cotransporter 2 inhibitors may, in part, be attributed to improved SNA.
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spelling pubmed-87519572022-01-14 Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure Hamaoka, Takuto Murai, Hisayoshi Hirai, Tadayuki Sugimoto, Hiroyuki Mukai, Yusuke Inoue, Oto Takashima, Shinichiro Kato, Takeshi Takata, Shigeo Usui, Soichiro Sakata, Kenji Kawashiri, Masa‐Aki Takamura, Masayuki J Am Heart Assoc Original Research BACKGROUND: Sodium‐glucose cotransporter 2 inhibitors improve cardiovascular outcomes in patients with diabetes with and without heart failure (HF). However, their influence on sympathetic nerve activity (SNA) remains unclear. The purpose of this study was to evaluate the effect of sodium‐glucose cotransporter 2 inhibitors on SNA and compare the responses of SNA to sodium‐glucose cotransporter 2 inhibitors in patients with type 2 diabetes with and without HF. METHODS AND RESULTS: Eighteen patients with type 2 diabetes, 10 with HF (65.4±3.68 years) and 8 without HF (63.3±3.62 years), were included. Muscle SNA (MSNA), heart rate, and blood pressure were recorded before and 12 weeks after administration of dapagliflozin (5 mg/day). Sympathetic and cardiovagal baroreflex sensitivity were simultaneously calculated. Brain natriuretic peptide level increased significantly at baseline in patients with HF than those without HF, while MSNA, blood pressure, and hemoglobin A1c did not differ between the 2 groups. Fasting blood glucose and homeostatic model assessment of insulin resistance did not change in either group after administering dapagliflozin. MSNA decreased significantly in both groups. However, the reduction in MSNA was significantly higher in patients with HF than patients with non‐HF (−20.2±3.46 versus −9.38±3.65 bursts/100 heartbeats; P=0.049), which was concordant with the decrease in brain natriuretic peptide. CONCLUSIONS: Dapagliflozin significantly decreased MSNA in patients with type 2 diabetes regardless of its blood glucose‐lowering effect. Moreover, the reduction in MSNA was more prominent in patients with HF than in patients with non‐HF. These results indicate that the cardioprotective effects of sodium‐glucose cotransporter 2 inhibitors may, in part, be attributed to improved SNA. John Wiley and Sons Inc. 2021-10-30 /pmc/articles/PMC8751957/ /pubmed/34719241 http://dx.doi.org/10.1161/JAHA.121.022637 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Hamaoka, Takuto
Murai, Hisayoshi
Hirai, Tadayuki
Sugimoto, Hiroyuki
Mukai, Yusuke
Inoue, Oto
Takashima, Shinichiro
Kato, Takeshi
Takata, Shigeo
Usui, Soichiro
Sakata, Kenji
Kawashiri, Masa‐Aki
Takamura, Masayuki
Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure
title Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure
title_full Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure
title_fullStr Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure
title_full_unstemmed Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure
title_short Different Responses of Muscle Sympathetic Nerve Activity to Dapagliflozin Between Patients With Type 2 Diabetes With and Without Heart Failure
title_sort different responses of muscle sympathetic nerve activity to dapagliflozin between patients with type 2 diabetes with and without heart failure
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751957/
https://www.ncbi.nlm.nih.gov/pubmed/34719241
http://dx.doi.org/10.1161/JAHA.121.022637
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