Diabetes Obes Metab. 2022 Jul 15.
Elena Succurro,
Patrizia Vizza,
Annalisa Papa,
Sofia Miceli,
Francesco Cicone,
Teresa Vanessa Fiorentino,
Angela Sciacqua,
Francesco Andreozzi,
Pierangelo Veltri,
Giuseppe Lucio Cascini,
Giorgio Sesti.
AIM: The primary aim of this study was to determine whether treatment with empagliflozin was able to affect myocardial glucose metabolic rate, assessed by cardiac dynamic 18 F-FDG-PET combined with a euglycemic-hyperinsulinemic clamp compared to glimepiride in patients with type 2 diabetes.MATERIALS AND METHODS: To further investigate the cardioprotective mechanism of SGLT2i we performed a 26-week, randomized, open-label, cross-over, active-comparator study to determine the effects of empagliflozin 10 mg versus glimepiride 2 mg daily on myocardial glucose metabolic rate assessed by cardiac dynamic 18 F-FDG-PET combined with a euglycemic-hyperinsulinemic clamp in 23 patients with type 2 diabetes. We also measured cardiac geometry, myocardial mechano-energetic efficiency, and systolic and diastolic function by echocardiography.
RESULTS: As compared with glimepiride, treatment with empagliflozin resulted in a greater reduction in myocardial glucose metabolic rate from baseline to 26 weeks (adjusted difference -6.07 μmol/min/100g, (-8.59, -3.55), P<0.0001). Moreover, empagliflozin led to significant reductions in left atrial diameter, left ventricular end-systolic and end-diastolic volumes, NT-proBNP levels, blood pressure, heart rate, stroke work, myocardial oxygen consumption, estimated by rate pressure product, and an increase in ejection fraction, myocardial mechano-energetic efficiency, red blood cells, hematocrit, and hemoglobin levels compared to glimepiride.
CONCLUSIONS: The present study provides evidence that empagliflozin treatment in subjects with type 2 diabetes without coronary artery disease leads to a significant reduction in myocardial glucose metabolic rate. This article is protected by copyright. All rights reserved.