Comparison of the effects of exenatide and insulin glargine on right and left ventricular myocardial deformation as shown by 2D-Speckle-tracking echocardiograms


Akyay O. Z., Sahin T., Cakmak Y., Tarkun I., Selek A., Canturk Z., ...Daha Fazla

NIGERIAN JOURNAL OF CLINICAL PRACTICE, cilt.25, sa.7, ss.1094-1101, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 7
  • Basım Tarihi: 2022
  • Doi Numarası: 10.4103/njcp.njcp_1640_21
  • Dergi Adı: NIGERIAN JOURNAL OF CLINICAL PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.1094-1101
  • Anahtar Kelimeler: 2D-speckle-tracking echocardiography, exenatide, insulin glargine, type 2 diabetes, ventricular dysfunction, GLUCAGON-LIKE PEPTIDE-1, SPECKLE-TRACKING ECHOCARDIOGRAPHY, CORONARY-ARTERY-DISEASE, CARDIOVASCULAR OUTCOMES, HEART-FAILURE, DIASTOLIC FUNCTION, DOUBLE-BLIND, EJECTION FRACTION, GLUCOSE-UPTAKE, LIRAGLUTIDE
  • Kocaeli Üniversitesi Adresli: Evet

Özet

Background: Exenatide is a glucagon-like peptide-1 (GLP-1) analogs. The effects of GLP-1 analogs on myocardial function are controversial. Aims: The purpose of this study is to compare the effects of exenatide and insulin glargine on subclinical right and left ventricular dysfunction. Methods and Material: In this study, 27 patients with type 2 diabetes were randomized into exenatide and insulin glargine treatment groups. The patients were monitored for six months by conventional echocardiography (ECHO) and 2D-speckle-tracking echocardiography (2D-STE) to evaluate right and left ventricular functions. Results: ECHO parameters did not change significantly pre- and post-treatment, except for the tricuspid annular plane systolic excursion (TAPSE) values. Post-treatment TAPSE values significantly increased in both groups compared to pre-treatment values. In the insulin group, values for 2D-STE parameters of the left ventricular global longitudinal strain (LVGLS) based on apical long-axis (ALA) images increased significantly (p: 0.047) compared to pre-treatment values; however, apical 4-chamber (A4C), apical 2-chamber (A2C), LVGLS, and right ventricular global longitudinal strain (RVGLS) values did not change. In the exenatide group, LVGLS based on A4C values improved (p: 0.048), while ALA, A2C, and LVGLS values did not change. Moreover, the RVGLS values improved significantly after exenatide treatment (p: 0.002). Based on 2D-STE parameters the two treatments did not differ statistically in either pre- or post-treatment periods. Conclusions: Glp-1 treatment can improve left ventricular regional and right ventricular global subclinical dysfunction. Therefore, early GLP-1 treatment may be recommended in diabetic patients with a high risk of cardiac dysfunction.