PMID- 38092177
OWN - NLM
STAT- Publisher
LR  - 20231223
IS  - 2241-5955 (Electronic)
IS  - 1109-9666 (Linking)
DP  - 2023 Dec 12
TI  - Effects of 3-month dapagliflozin on left atrial function in treatment-naive 
      patients with type 2 diabetes mellitus: Assessment using 4-dimensional 
      echocardiography.
LID - S1109-9666(23)00228-2 [pii]
LID - 10.1016/j.hjc.2023.12.002 [doi]
AB  - BACKGROUND: The sodium-glucose transporter-2 (SGLT-2) inhibitor dapagliflozin can 
      improve left ventricular (LV) performance in patients with type 2 diabetes 
      mellitus (T2DM). However, the effects on left atrial (LA) function in 
      treatment-naive T2DM patients remain unclear. The aim of our study was 1) to 
      investigate the effects of 3-month treatment with dapagliflozin on LA function in 
      treatment-naive patients with T2DM using 4-dimensional automated LA 
      quantification (4D Auto LAQ) and 2) to explore linked covariation patterns of 
      changes in clinical and LA echocardiographic variables. METHODS: 4D Auto LAQ was 
      used to evaluate LA volumes, longitudinal and circumferential strains in 
      treatment-naive T2DM patients at baseline, at follow-up, and in healthy control 
      (HC). Sparse canonical correlation analysis (sCCA) was performed to capture the 
      linked covariation patterns between changes in clinical and LA echocardiographic 
      variables within the treatment-naive T2DM patient group. RESULTS: This study 
      finally included 61 treatment-naive patients with T2DM without cardiovascular 
      disease and 39 healthy controls (HC). Treatment-naive T2DM patients showed 
      reduced LA reservoir and conduit function at baseline compared to HC, independent 
      of age, sex, BMI, and blood pressure (LASr: 21.11 +/- 5.39 vs. 27.08 +/- 5.31 %, 
      p(adjusted) = 0.017; LAScd: -11.51 +/- 4.48 vs. -16.74 +/- 4.51 %, 
      p(adjusted) = 0.013). After 3-month treatment with dapagliflozin, T2DM patients 
      had significant improvements in LA reservoir and conduit function independent of 
      BMI and blood pressure changes (LASr: 21.11 +/- 5.39 vs. 23.84 +/- 5.74 %, 
      p(adjusted) < 0.001; LAScd: -11.51 +/- 4.48 vs. -12.75 +/- 4.70 %, 
      p(adjusted) < 0.001). The clinical and LA echocardiographic parameters showed 
      significant covariation (r = 0.562, p = 0.039). In the clinical dataset, changes 
      in heart rate, insulin, and BMI were most associated with the LA 
      echocardiographic variate. In the LA echocardiographic dataset, changes in LAScd, 
      LASr, and LASr_c were most associated with the clinical variate. CONCLUSION: 
      Compared with HC, treatment-naive patients with T2DM had lower LA function, and 
      these patients benefited from dapagliflozin administration, particularly in LA 
      function.
CI  - Copyright (c) 2023 Hellenic Society of Cardiology. Published by Elsevier B.V. All 
      rights reserved.
FAU - Zhang, Miao
AU  - Zhang M
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Sun, Lanlan
AU  - Sun L
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Wu, Xiaopeng
AU  - Wu X
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Qin, Yunyun
AU  - Qin Y
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Lin, Mingming
AU  - Lin M
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Ding, Xueyan
AU  - Ding X
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Zhu, Weiwei
AU  - Zhu W
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Jiang, Zhe
AU  - Jiang Z
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Jin, Shan
AU  - Jin S
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Leng, Chenlei
AU  - Leng C
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China.
FAU - Wang, Jiangtao
AU  - Wang J
AD  - GE Clinical Education Team, Beijing 100176, China.
FAU - Lv, Xiuzhang
AU  - Lv X
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China. Electronic address: lxz_echo@163.com.
FAU - Cai, Qizhe
AU  - Cai Q
AD  - Department of Ultrasound Medicine, Beijing Chao Yang Hospital, Capital Medical 
      University, Beijing 100020, China. Electronic address: echocaiqizhe@163.com.
LA  - eng
PT  - Journal Article
DEP - 20231212
PL  - Netherlands
TA  - Hellenic J Cardiol
JT  - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
JID - 101257381
SB  - IM
OTO - NOTNLM
OT  - 4-dimensional echocardiography
OT  - Dapagliflozin
OT  - Left atrial function
OT  - Sparse canonical correlation analysis
OT  - Type 2 diabetes mellitus
COIS- Declaration of competing interest The authors declare that the research was 
      conducted in the absence of any commercial or financial relationships that could 
      be construed as a potential conflict of interest.
EDAT- 2023/12/14 00:42
MHDA- 2023/12/14 00:42
CRDT- 2023/12/13 19:26
PHST- 2023/08/13 00:00 [received]
PHST- 2023/11/21 00:00 [revised]
PHST- 2023/12/09 00:00 [accepted]
PHST- 2023/12/14 00:42 [pubmed]
PHST- 2023/12/14 00:42 [medline]
PHST- 2023/12/13 19:26 [entrez]
AID - S1109-9666(23)00228-2 [pii]
AID - 10.1016/j.hjc.2023.12.002 [doi]
PST - aheadofprint
SO  - Hellenic J Cardiol. 2023 Dec 12:S1109-9666(23)00228-2. doi: 
      10.1016/j.hjc.2023.12.002.