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Dynamics of Epicardiac Fat and Heart Function in Type 2 Diabetic Patients Initiated with SGLT-2 Inhibitors

Authors Braha A, Timar B, Diaconu L, Lupusoru R, Vasiluta L, Sima A, Vlad A, Munteanu M, Albai A, Cipu D, Timar R

Received 18 July 2019

Accepted for publication 23 October 2019

Published 5 December 2019 Volume 2019:12 Pages 2559—2566


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Juei-Tang Cheng

Adina Braha,1 Bogdan Timar,2 Laura Diaconu,3 Raluca Lupusoru,1,4 Lucian Vasiluta,3 Alexandra Sima,3 Adrian Vlad,3 Mircea Munteanu,3 Alin Albai,3 Daniela Cipu,5 Romulus Timar3

1First Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 3Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 4Department of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 5Department of Orthopedics-Traumatology, Urology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania

Correspondence: Bogdan Timar
Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu, Timisoara 300041, Romania
Tel +40 741 528 093
Fax +40 256 462 856

Purpose: The aim of this study was to assess the dynamics of epicardiac adipose tissue (EAT) thickness and total volume as well as that of systolic and diastolic dysfunction in a group of patients with type 2 diabetes (T2D) after initiation of sodium glucose co-transporter 2 (SGLT 2) inhibitors therapy.
Patients and methods: This prospective, observational study included 53 patients with T2D who received SGLT-2 inhibitors for 24 weeks. In all patients, echocardiographic screening for EAT, systolic and diastolic dysfunction and non-contrast computed tomography scans were performed, both before and after 24 weeks of SGLT-2 inhibition. Imagistic evaluation was followed by the association’s analysis between the dynamics of EAT and heart function, as well as the patient’s clinical and biological parameters. We considered a decrease or increase of more than 10% in EAT as being clinically significant.
Results: The mean volume of EAT decreased significantly after SGLT 2 inhibition (37.8±17.2 vs. 20.7±7 cm3; p<0.001). Median values of EAT thickness also decreased significantly (5.95 vs. 3.01 mm; p<0.001). Most patients, 75.4% (40/53), presented more than 10% decrease in EAT volume, 9.5% (5/53) had stable EAT volume values, while in 15.1% (8/53) the means of EAT volume increased. 73.5% of the patients had diastolic dysfunction type 1 (DD 1) at baseline. No significant change was observed in the left ventricular ejection fraction or diastolic dysfunction after 24 weeks of treatment. Although not statistically significant, an improvement in cardiac function has been noticed throughout the duration of 1 year of treatment with SGLT 2 inhibitors.
Conclusion: This study showed the beneficial effect of SGLT 2 inhibitors on EAT after a short period of treatment, but there were no significant changes in the systolic function during the 1st year of study. However, reducing epicardial fat has led to remission of diastolic dysfunction.

Keywords: epicardiac fat, diastolic dysfunction, heart failure

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