PMID- 31653956
OWN - NLM
STAT- MEDLINE
DCOM- 20201030
LR  - 20210110
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 9
IP  - 1
DP  - 2019 Oct 25
TI  - Effect of Empagliflozin on Cardiac Function, Adiposity, and Diffuse Fibrosis in 
      Patients with Type 2 Diabetes Mellitus.
PG  - 15348
LID - 10.1038/s41598-019-51949-5 [doi]
LID - 15348
AB  - Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, significantly 
      improves cardiovascular outcomes in diabetic patients; however, the mechanism is 
      unclear. We hypothesized that empagliflozin might have beneficial effects on 
      cardiac function, structure, adiposity, and myocardial diffuse fibrosis. This 
      prospective study enrolled 35 patients (48.6% men, age 63.5 +/- 9.7 years) with 
      type 2 diabetes mellitus (T2DM) from June 1, 2017, to November 31, 2018. The 
      patients received an SGLT2 inhibitor (empagliflozin 25 or 12.5 mg/d) for 6 months 
      in addition to stable oral hypoglycaemic treatment. All patients underwent 
      cardiac magnetic resonance imaging (CMRI) before and after empagliflozin 
      treatment. Left ventricular (LV) function and structure were quantified using 
      cine CMRI. Cardiac adiposity was defined based on pericardial fat and 
      intracardiac triglyceride contents, whereas myocardial diffuse fibrosis was 
      indicated by extracellular volume (ECV). The statistical significance of 
      parameter changes was assessed using paired t-test and stepwise multiple linear 
      regression. There were no significant differences in LV function and structure 
      changes. Cardiac adiposity and diffuse fibrosis indices were also not different 
      before and after empagliflozin treatment. Concerning clinical parameters, only a 
      significant decrease in systolic blood pressure (by 6.4 mmHg) was observed 
      (p = 0.013). Stepwise multiple linear regression revealed that worse baseline MRI 
      parameters were associated with better improvements. Intracardiac triglyceride 
      content decrease was inversely associated with baseline intracardiac triglyceride 
      content (p < 0.001). Pericardial fat changes were negatively correlated with 
      baseline pericardial fat (p < 0.001) and ECV changes (p = 0.028). ECV changes 
      were inversely associated with baseline ECV (p < 0.001), baseline LV ejection 
      fraction (p < 0.001), and LV mass index changes (p = 0.020). This study 
      demonstrated that 6 months of empagliflozin treatment did not significantly 
      improve the LV function, structure, adiposity, and diffuse fibrosis in patients 
      with T2DM. Further, the beneficial effects of empagliflozin treatment might be 
      more evident in patients with worse baseline LV substrate and structure.
FAU - Hsu, Jung-Chi
AU  - Hsu JC
AD  - Department of Internal Medicine, Division of Cardiology, Saint Mary's Hospital 
      Luodong, Yilan, 26546, Taiwan.
AD  - Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, 
      10617, Taiwan.
FAU - Wang, Chih-Yuan
AU  - Wang CY
AD  - Department of Internal Medicine, Division of Endocrinology, National Taiwan 
      University Hospital and College of Medicine, National Taiwan University, Taipei, 
      10617, Taiwan.
FAU - Su, Mao-Yuan M
AU  - Su MM
AUID- ORCID: 0000-0002-6699-2298
AD  - Department of Medical Imaging, National Taiwan University of College of Medicine, 
      Taipei, 10617, Taiwan.
FAU - Lin, Lian-Yu
AU  - Lin LY
AUID- ORCID: 0000-0002-9281-1171
AD  - Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, 
      10617, Taiwan. hspenos@gmail.com.
AD  - Department of Internal Medicine, Division of Cardiology, National Taiwan 
      University Hospital and College of Medicine, National Taiwan University, Taipei, 
      10617, Taiwan. hspenos@gmail.com.
FAU - Yang, Wei-Shiung
AU  - Yang WS
AD  - Department of Internal Medicine, Division of Endocrinology, National Taiwan 
      University Hospital and College of Medicine, National Taiwan University, Taipei, 
      10617, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191025
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Benzhydryl Compounds)
RN  - 0 (Glucosides)
RN  - 0 (Triglycerides)
RN  - HDC1R2M35U (empagliflozin)
SB  - IM
MH  - *Adiposity/drug effects
MH  - Benzhydryl Compounds/*therapeutic use
MH  - Diabetes Mellitus, Type 2/*drug therapy/*physiopathology
MH  - Female
MH  - Fibrosis
MH  - Glucosides/*therapeutic use
MH  - Heart Function Tests/drug effects
MH  - Heart Ventricles/drug effects/pathology/physiopathology
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardium/metabolism
MH  - Triglycerides/metabolism
PMC - PMC6814842
COIS- The authors declare no competing interests.
EDAT- 2019/10/28 06:00
MHDA- 2020/10/31 06:00
PMCR- 2019/10/25
CRDT- 2019/10/27 06:00
PHST- 2019/04/18 00:00 [received]
PHST- 2019/10/10 00:00 [accepted]
PHST- 2019/10/27 06:00 [entrez]
PHST- 2019/10/28 06:00 [pubmed]
PHST- 2020/10/31 06:00 [medline]
PHST- 2019/10/25 00:00 [pmc-release]
AID - 10.1038/s41598-019-51949-5 [pii]
AID - 51949 [pii]
AID - 10.1038/s41598-019-51949-5 [doi]
PST - epublish
SO  - Sci Rep. 2019 Oct 25;9(1):15348. doi: 10.1038/s41598-019-51949-5.