Effect of Liraglutide on Cardiovascular Function and Myocardial Tissue Characteristics in Type 2 Diabetes Patients of South Asian Descent Living in the Netherlands: A Double-Blind, Randomized, Placebo-Controlled Trial.

Abstract

BackgroundThe glucagon‐like peptide‐1 (GLP‐1) receptor agonist liraglutide may be beneficial in the regression of diabetic cardiomyopathy. South Asian ethnic groups in particular are at risk of developing type 2 diabetes.PurposeTo assess the effects of liraglutide on left ventricular (LV) diastolic and systolic function in South Asian type 2 diabetes patients.Study TypeProspective, double‐blind, randomized, placebo‐controlled trial.PopulationForty‐seven type 2 diabetes patients of South Asian ancestry living in the Netherlands, with or without ischemic heart disease, who were randomly assigned to 26‐week treatment with liraglutide (1.8 mg/day) or placebo.Field Strength/Sequence3T (balanced steady‐state free precession cine MRI, 2D and 4D velocity‐encoded MRI, 1H‐MRS, T1 mapping).AssessmentPrimary endpoints were changes in LV diastolic function (early deceleration peak [Edec], ratio of early and late peak filling rate [E/A], estimated LV filling pressure [E/Ea]) and LV systolic function (ejection fraction). Secondary endpoints were changes in aortic stiffness (aortic pulse wave velocity [PWV]), myocardial steatosis (myocardial triglyceride content), and diffuse fibrosis (extracellular volume [ECV]).Statistical TestsData were analyzed according to intention‐to‐treat. Between‐group differences were reported as mean (95% confidence interval [CI]) and were assessed using analysis of covariance (ANCOVA).ResultsLiraglutide (n = 22) compared with placebo (n = 25) did not change Edec (+0.2 mL/s2 × 10‐3 (–0.3;0.6)), E/A (–0.09 (–0.23;0.05)), E/Ea (+0.1 (–1.2;1.3)) and ejection fraction (0% (–3;2)), but decreased stroke volume (–9 mL (–14;–5)) and increased heart rate (+10 bpm (4;15)). Aortic PWV (+0.5 m/s (–0.6;1.6)), myocardial triglyceride content (+0.21% (–0.09;0.51)), and ECV (–0.2% (–1.4;1.0)) were unaltered.Data ConclusionLiraglutide did not affect LV diastolic and systolic function, aortic stiffness, myocardial triglyceride content, or extracellular volume in Dutch South Asian type 2 diabetes patients with or without coronary artery disease. Level of Evidence: 1 Technical Efficacy Stage: 4J. Magn. Reson. Imaging 2020;51:1679–1688.