Effects of exenatide on cardiac function, perfusion, and energetics in type 2 diabetic patients with cardiomyopathy: a randomized controlled trial against insulin glargine

Cardiovascular Diabetology

Original Investigation

Paul Knaapen¹  Karin de Boer¹  Albert C. van Rossum¹  Lourens F. H. J. Robbers¹  Adriaan A. Lammertsma²  Hendrik J. Harms²  Michaela Diamant³  Weena J. Y. Chen³  Mark H. H. Kramer³ 

[1] Department of Cardiology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;Department of Radiology and Nuclear Medicine, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;Diabetes Center/Department of Internal Medicine, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;

关键词: Diabetes mellitus type 2;    Exenatide;    Cardiac function;    Myocardial perfusion;    Myocardial oxidative metabolism;   

DOI  :  10.1186/s12933-017-0549-z

 received in 2017-03-02, accepted in 2017-05-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMultiple bloodglucose-lowering agents have been linked to cardiovascular events. Preliminary studies showed improvement in left ventricular (LV) function during glucagon-like peptide-1 receptor agonist administration. Underlying mechanisms, however, are unclear. The purpose of this study was to investigate myocardial perfusion and oxidative metabolism in type 2 diabetic (T2DM) patients with LV systolic dysfunction as compared to healthy controls. Furthermore, effects of 26-weeks of exenatide versus insulin glargine administration on cardiac function, perfusion and oxidative metabolism in T2DM patients with LV dysfunction were explored.Methods and resultsTwenty-six T2DM patients with LV systolic dysfunction (cardiac magnetic resonance (CMR) derived LV ejection fraction (LVEF) of 47 ± 13%) and 10 controls (LVEF of 59 ± 4%, P < 0.01 as compared to patients) were analyzed. Both myocardial perfusion during adenosine-induced hyperemia (P < 0.01), and coronary flow reserve (P < 0.01), measured by [15O]H2O positron emission tomography (PET), were impaired in T2DM patients as compared to healthy controls. Myocardial oxygen consumption and myocardial efficiency, measured using [11C]acetate PET and CMR derived stroke volume, were not different between the groups. Eleven patients in the exenatide group and 12 patients in the insulin glargine group completed the trial. Systemic metabolic control was improved after both treatments, although, no changes in cardiac function, perfusion and metabolism were seen after exenatide or insulin glargine.ConclusionsT2DM patients with LV systolic dysfunction did not have altered myocardial efficiency as compared to healthy controls. Exenatide or insulin glargine had no effects on cardiac function, perfusion or oxidative metabolism.Trial registration NCT00766857

【 授权许可】

CC BY   
© The Author(s) 2017