Liraglutide improves cardiac function in patients with type 2 diabetes and chronic heart failure
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ORIGINAL ARTICLE
Liraglutide improves cardiac function in patients with type 2 diabetes and chronic heart failure F. Arturi1 E. Succurro1 S. Miceli1 C. Cloro2 M. Ruffo1 R. Maio3 M. Perticone4 G. Sesti1 F. Perticone1 ●
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Received: 27 April 2016 / Accepted: 1 November 2016 © Springer Science+Business Media New York 2016
Abstract Purpose To compare the effect of liraglutide, sitagliptin and insulin glargine added to standard therapy on left ventricular function in post-ischemic type-2 diabetes mellitus patients. Methods We evaluated 32 type-2 diabetes mellitus Caucasians with history of post-ischemic chronic heart failure NYHA class II/III and/or left ventricular ejection fraction ≤45 %. Participants underwent laboratory determinations, electrocardiogram, echocardiogram, Minnesota Living with Heart Failure questionnaire and 6 min walking test at baseline and following 52 weeks treatment. Patients were treated with standard therapy for chronic heart failure and were randomized to receive liraglutide, sitagliptin and glargine in addition to metformin and/or sulfonylurea. Results Liraglutide treatment induced an improvement in left ventricular ejection fraction from 41.5 ± 2.2 to 46.3 ± 3 %; P = 0.001). On the contrary, treatment with sitagliptin and glargine induced no changes in left ventricular ejection fraction (41.8 ± 2.6 vs. 42.5 ± 2.5 % and 42 ± 1.5 vs. 42 ± 1.6 %, respectively; P = NS). Indexed end-systolic LV
F. Arturi and E. Succurro equally contributed to the work * F. Perticone [email protected] 1
Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Policlinico “Mater Domini”, Campus Universitario, Viale Europa, 88100, Catanzaro, Italy
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Unit of Cardiology “S.S. Annunziata” Hospital of Cosenza, Cosenza, Italy
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Azienda Ospedaliera Mater Domini, Catanzaro, Italy
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Department of Clinical and Experimental Medicine, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
volume was reduced only in liraglutide-treated patients (51 ± 9 vs. 43 ± 8 ml/m2; P < 0.05). Liraglutide treatment induced also a significant increase in the anterograde stroke volume (39 ± 9 vs. 49 ± 11 ml; P < 0.05), whereas no differences were observed in the other two groups. Cardiac output and cardiac index showed a significant increase only in liraglutide-treated patients (4.4 ± 0.5 vs. 5.0 ± 0.6 L/min; P < 0.05 and 1.23 ± 0.26 vs. 1.62 ± 0.29 L/m2; P = 0.005, respectively). Liraglutide treatment was also associated with an improvement of functional capacity and an improvement of quality of life. Conclusions These data provide evidence that treatment with liraglutide is associated with improvement of cardiac function and functional capacity in failing post-ischemic type-2 diabetes mellitus patients. Keywords Chronic heart failure Type 2 diabetes Liraglutide Glucagon-like peptide-1 Left ventricular ejection fraction Cardiac function ●
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Introduction Type 2 diabetes mellitus (T2DM) is a powerful and independent risk factor for the development and prognosis of congesti
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