Effects of SGLT2 Inhibitors on Rest Myocardial Perfusion in Patients with Type 2 Diabetes and Diabetic Nephropathy

Abstract

BackgroundHave been shown, sodium-glucose cotransporter 2 inhibitor (SGLT2i) therapy was associated with risk reductions in cardiorenal endpoints. The aim of our study was to study effects of SGLT2i on myocardial perfusion (MP) at rest, in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). Methods and Results43 patients with DM2 and DN, CKD (Stages 1–3) without cardiovascular complaints were examined. We randomized 33 patients to either empagliflozin 10/25mg (n=15) or dapagliflozin 10mg (n=18) once daily for 6 months, as add‐on to standard therapy and 10 patients not taking SGLT2i entered the control group. Informed consent was obtaining from each patient prior to the study. Myocardial perfusion imaging was performed using SPECT - AnyScan® SC - Mediso with technetium-99m sestamibi.Baseline mean MP (MMP) of the 17 left ventricular segments was 85.34±3.89%. There was no change from baseline in MMP at 6 months in either the empagliflozin: 83.69±5.03 to 83.33±2.83% (p=0.84) or dapagliflozin groups: 85.68±3.32 to 85.29±4.3% (p=0.68), but in the control group there was a significant decrease in MMP from 87.68±3.13 to 83.01±2.71% (p=0.03). ConclusionsEmpagliflozin and dapagliflozin did not improve MMP in patients with T2DM and CKD. but in relation to the control group, which experienced a deterioration in MMP, SGLT2i helped to maintain the average level of MMP, which shows a cardioprotective effect.