Skip to main content
Erschienen in: Acta Diabetologica 1/2024

10.09.2023 | Original Article

Relationship between saxagliptin use and left ventricular diastolic function assessed by cardiac MRI

verfasst von: Kathy C. K. Wong, Huda S. Ismail, Kim A. Connelly, Subodh Verma, Ming-Yen Ng, Djeven P. Deva, Andrew T. Yan, Laura Jimenez-Juan

Erschienen in: Acta Diabetologica | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Aims

Type 2 diabetes mellitus (T2DM) increases the risk of major cardiovascular events. In SAVOR-TIMI53 trial, the excess heart failure (HF) hospitalization among patients with T2DM in the saxagliptin group remains poorly understood. Our aim was to evaluate left ventricular (LV) diastolic function after 6 months of saxagliptin treatment using cardiac magnetic resonance imaging (CMR) in patients with T2DM.

Methods

In this prospective study, 16 T2DM patients without HF were prescribed saxagliptin as part of routine guideline-directed management. CMR performed at baseline and 6 months after initiation of saxagliptin treatment were evaluated in a blinded fashion. We assessed LV diastolic function by measuring LV peak filling rate with correction for end-diastolic volume (PFR/LVEDV), time to peak filling rate with correction for cardiac cycle (TPF/RR), and early diastolic strain rate parameters [global longitudinal diastolic strain rate (GLSR-E), global circumferential diastolic strain rate (GCSR-E)] by feature tracking (FT-CMR).

Results

Among the 16 patients (mean age of 59.9, 69% males, mean hemoglobin A1c 8.3%, mean left ventricular ejection fraction 57%), mean PFR was 314 ± 108 ml/s at baseline and did not change over 6 months (− 2.7, 95% CI − 35.6, 30.2, p = 0.86). There were also no significant changes in other diastolic parameters including PFR/EDV, TPF, TPF/RR, and GLSR-E and GCSR-E (all p > 0.50).

Conclusion

In T2DM patients without HF receiving saxagliptin over 6 months, there were no significant subclinical changes in LV diastolic function as assessed by CMR.
Literatur
2.
Zurück zum Zitat Lipscombe L, Butalia S, Dasgupta K et al (2020) Pharmacologic glycemic management of type 2 diabetes in adults: 2020 update. Can J Diabetes 44:575–591CrossRefPubMed Lipscombe L, Butalia S, Dasgupta K et al (2020) Pharmacologic glycemic management of type 2 diabetes in adults: 2020 update. Can J Diabetes 44:575–591CrossRefPubMed
3.
Zurück zum Zitat Lo S, Leiter LA, Langer A et al (2021) Cardiovascular risk factor management in patients with diabetes: does management differ with disease duration? J Diabetes Complicat 35:107997CrossRef Lo S, Leiter LA, Langer A et al (2021) Cardiovascular risk factor management in patients with diabetes: does management differ with disease duration? J Diabetes Complicat 35:107997CrossRef
4.
Zurück zum Zitat Scirica BM, Bhatt DL, Braunwald E et al (2013) Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med 369:1317–1326CrossRefPubMed Scirica BM, Bhatt DL, Braunwald E et al (2013) Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med 369:1317–1326CrossRefPubMed
5.
Zurück zum Zitat Scirica BM, Braunwald E, Raz I et al (2014) Heart failure, saxagliptin, and diabetes mellitus: observations from the SAVOR-TIMI 53 randomized trial. Circulation 130:1579–1588CrossRefPubMed Scirica BM, Braunwald E, Raz I et al (2014) Heart failure, saxagliptin, and diabetes mellitus: observations from the SAVOR-TIMI 53 randomized trial. Circulation 130:1579–1588CrossRefPubMed
6.
Zurück zum Zitat Bellenger NG, Davies LC, Francis JM, Coats AJ, Pennell DJ (2000) Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2:271–278CrossRefPubMed Bellenger NG, Davies LC, Francis JM, Coats AJ, Pennell DJ (2000) Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2:271–278CrossRefPubMed
9.
Zurück zum Zitat Zile MR, Brutsaert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: part I: diagnosis, prognosis, and measurements of diastolic function. Circulation 105:1387–1393CrossRefPubMed Zile MR, Brutsaert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: part I: diagnosis, prognosis, and measurements of diastolic function. Circulation 105:1387–1393CrossRefPubMed
10.
Zurück zum Zitat Aljaroudi W, Alraies MC, Halley C et al (2012) Impact of progression of diastolic dysfunction on mortality in patients with normal ejection fraction. Circulation 125:782–788CrossRefPubMed Aljaroudi W, Alraies MC, Halley C et al (2012) Impact of progression of diastolic dysfunction on mortality in patients with normal ejection fraction. Circulation 125:782–788CrossRefPubMed
11.
Zurück zum Zitat Sandhu P, Ong JP, Garg V et al (2021) The effects of saxagliptin on cardiac structure and function using cardiac MRI (SCARF). Acta Diabetol 58:633–641CrossRefPubMed Sandhu P, Ong JP, Garg V et al (2021) The effects of saxagliptin on cardiac structure and function using cardiac MRI (SCARF). Acta Diabetol 58:633–641CrossRefPubMed
12.
Zurück zum Zitat Paelinck BP, Lamb HJ, Bax JJ, Van der Wall EE, de Roos A (2002) Assessment of diastolic function by cardiovascular magnetic resonance. Am Heart J 144:198–205CrossRefPubMed Paelinck BP, Lamb HJ, Bax JJ, Van der Wall EE, de Roos A (2002) Assessment of diastolic function by cardiovascular magnetic resonance. Am Heart J 144:198–205CrossRefPubMed
13.
Zurück zum Zitat Gong IY, Ong G, Brezden-Masley C et al (2019) Early diastolic strain rate measurements by cardiac MRI in breast cancer patients treated with trastuzumab: a longitudinal study. Int J Cardiovasc Imaging 35:653–662CrossRefPubMed Gong IY, Ong G, Brezden-Masley C et al (2019) Early diastolic strain rate measurements by cardiac MRI in breast cancer patients treated with trastuzumab: a longitudinal study. Int J Cardiovasc Imaging 35:653–662CrossRefPubMed
15.
Zurück zum Zitat Ng MY, Tong X, He J et al (2020) Feature tracking for assessment of diastolic function by cardiovascular magnetic resonance imaging. Clin Radiol 75:321 e1-321 e1CrossRefPubMed Ng MY, Tong X, He J et al (2020) Feature tracking for assessment of diastolic function by cardiovascular magnetic resonance imaging. Clin Radiol 75:321 e1-321 e1CrossRefPubMed
16.
Zurück zum Zitat McMurray JJV, Ponikowski P, Bolli GB et al (2018) Effects of vildagliptin on ventricular function in patients with type 2 diabetes mellitus and heart failure: a randomized placebo-controlled trial. JACC Heart Fail 6:8–17CrossRefPubMed McMurray JJV, Ponikowski P, Bolli GB et al (2018) Effects of vildagliptin on ventricular function in patients with type 2 diabetes mellitus and heart failure: a randomized placebo-controlled trial. JACC Heart Fail 6:8–17CrossRefPubMed
17.
Zurück zum Zitat Nogueira KC, Furtado M, Fukui RT et al (2014) Left ventricular diastolic function in patients with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor: a pilot study. Diabetol Metab Syndr 6:103CrossRefPubMedPubMedCentral Nogueira KC, Furtado M, Fukui RT et al (2014) Left ventricular diastolic function in patients with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor: a pilot study. Diabetol Metab Syndr 6:103CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Yamada H, Tanaka A, Kusunose K et al (2017) Effect of sitagliptin on the echocardiographic parameters of left ventricular diastolic function in patients with type 2 diabetes: a subgroup analysis of the PROLOGUE study. Cardiovasc Diabetol 16:63CrossRefPubMedPubMedCentral Yamada H, Tanaka A, Kusunose K et al (2017) Effect of sitagliptin on the echocardiographic parameters of left ventricular diastolic function in patients with type 2 diabetes: a subgroup analysis of the PROLOGUE study. Cardiovasc Diabetol 16:63CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Green JB, Bethel MA, Armstrong PW et al (2015) Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N Engl J Med 373:232–242CrossRefPubMed Green JB, Bethel MA, Armstrong PW et al (2015) Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N Engl J Med 373:232–242CrossRefPubMed
20.
Zurück zum Zitat Toh S, Hampp C, Reichman ME et al (2016) Risk for hospitalized heart failure among new users of saxagliptin, sitagliptin, and other antihyperglycemic drugs: a retrospective cohort study. Ann Intern Med 164:705–714CrossRefPubMedPubMedCentral Toh S, Hampp C, Reichman ME et al (2016) Risk for hospitalized heart failure among new users of saxagliptin, sitagliptin, and other antihyperglycemic drugs: a retrospective cohort study. Ann Intern Med 164:705–714CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Borlaug BA, Redfield MM (2011) Diastolic and systolic heart failure are distinct phenotypes within the heart failure spectrum. Circulation 123:2006–2013CrossRefPubMedPubMedCentral Borlaug BA, Redfield MM (2011) Diastolic and systolic heart failure are distinct phenotypes within the heart failure spectrum. Circulation 123:2006–2013CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Wong TC, Piehler KM, Kang IA et al (2014) Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in diabetes and associated with mortality and incident heart failure admission. Eur Heart J 35:657–664CrossRefPubMed Wong TC, Piehler KM, Kang IA et al (2014) Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in diabetes and associated with mortality and incident heart failure admission. Eur Heart J 35:657–664CrossRefPubMed
23.
Zurück zum Zitat Shang Y, Zhang X, Leng W et al (2017) Assessment of diabetic cardiomyopathy by cardiovascular magnetic resonance T1 mapping: correlation with left-ventricular diastolic dysfunction and diabetic duration. J Diabetes Res 2017:9584278CrossRefPubMedPubMedCentral Shang Y, Zhang X, Leng W et al (2017) Assessment of diabetic cardiomyopathy by cardiovascular magnetic resonance T1 mapping: correlation with left-ventricular diastolic dysfunction and diabetic duration. J Diabetes Res 2017:9584278CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Caudron J, Fares J, Bauer F, Dacher JN (2011) Evaluation of left ventricular diastolic function with cardiac MR imaging. Radiographics 31:239–259CrossRefPubMed Caudron J, Fares J, Bauer F, Dacher JN (2011) Evaluation of left ventricular diastolic function with cardiac MR imaging. Radiographics 31:239–259CrossRefPubMed
25.
Zurück zum Zitat Kankanala SR, Syed R, Gong Q, Ren B, Rao X, Zhong J (2016) Cardiovascular safety of dipeptidyl peptidase-4 inhibitors: recent evidence on heart failure. Am J Transl Res 8:2450–2458PubMedPubMedCentral Kankanala SR, Syed R, Gong Q, Ren B, Rao X, Zhong J (2016) Cardiovascular safety of dipeptidyl peptidase-4 inhibitors: recent evidence on heart failure. Am J Transl Res 8:2450–2458PubMedPubMedCentral
26.
Zurück zum Zitat Tadic M, Sala C, Saeed S et al (2022) New antidiabetic therapy and HFpEF: light at the end of tunnel? Heart Fail Rev 27:1137–1146CrossRefPubMed Tadic M, Sala C, Saeed S et al (2022) New antidiabetic therapy and HFpEF: light at the end of tunnel? Heart Fail Rev 27:1137–1146CrossRefPubMed
27.
Zurück zum Zitat Connelly KA, Zhang Y, Advani A et al (2013) DPP-4 inhibition attenuates cardiac dysfunction and adverse remodeling following myocardial infarction in rats with experimental diabetes. Cardiovasc Ther 31:259–267CrossRefPubMed Connelly KA, Zhang Y, Advani A et al (2013) DPP-4 inhibition attenuates cardiac dysfunction and adverse remodeling following myocardial infarction in rats with experimental diabetes. Cardiovasc Ther 31:259–267CrossRefPubMed
28.
Zurück zum Zitat Hiemstra JA, Lee DI, Chakir K et al (2016) Saxagliptin and tadalafil differentially alter cyclic guanosine monophosphate (cGMP) signaling and left ventricular function in aortic-banded mini-swine. J Am Heart Assoc 5:e003277CrossRefPubMedPubMedCentral Hiemstra JA, Lee DI, Chakir K et al (2016) Saxagliptin and tadalafil differentially alter cyclic guanosine monophosphate (cGMP) signaling and left ventricular function in aortic-banded mini-swine. J Am Heart Assoc 5:e003277CrossRefPubMedPubMedCentral
Metadaten
Titel
Relationship between saxagliptin use and left ventricular diastolic function assessed by cardiac MRI
verfasst von
Kathy C. K. Wong
Huda S. Ismail
Kim A. Connelly
Subodh Verma
Ming-Yen Ng
Djeven P. Deva
Andrew T. Yan
Laura Jimenez-Juan
Publikationsdatum
10.09.2023
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 1/2024
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-023-02177-x

Weitere Artikel der Ausgabe 1/2024

Acta Diabetologica 1/2024 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

16.05.2024 alpha-1-Rezeptorantagonisten Nachrichten

Nach einer Prostatabiopsie treten häufig Probleme beim Wasserlassen auf. Ob sich das durch den periinterventionellen Einsatz von Alphablockern verhindern lässt, haben australische Mediziner im Zuge einer Metaanalyse untersucht.

Eingreifen von Umstehenden rettet vor Erstickungstod!

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Neue S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Schadet Ärger den Gefäßen?

14.05.2024 Arteriosklerose Nachrichten

In einer Studie aus New York wirkte sich Ärger kurzfristig deutlich negativ auf die Endothelfunktion gesunder Probanden aus. Möglicherweise hat dies Einfluss auf die kardiovaskuläre Gesundheit.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.