Abstract
We aimed to investigate the effect of liraglutide treatment on heart function in type 2 diabetes (T2D) patients with subclinical heart failure. Randomized open parallel-group trial. 62 T2D patients (45 male) with subclinical heart failure were randomized to either once daily liraglutide 1.8 mg, or glimepiride 4 mg, both add on to metformin 1 g twice a day. Mitral annular systolic (s') and early diastolic (e') velocities were measured at rest and during bicycle ergometer exercise, using tissue Doppler echocardiography. The primary endpoint was 18-week treatment changes in longitudinal functional reserve index (LFRIdiastolic/systolic). Clinical characteristics between groups (liraglutide = 33 vs. glimepiride = 29) were well matched. At baseline left ventricle ejection fraction (53.7 vs. 53.6%) and global longitudinal strain (-15.3 vs. -16.5%) did not differ between groups. There were no significant differences in mitral flow velocities between groups. For the primary endpoint, there was no treatment change [95% confidence interval] for: LFRIdiastolic (-0.18 vs. -0.53 [-0.28, 2.59; p = 0.19]), or LFRIsystolic (-0.10 vs. -0.18 [-1.0, 1.7; p = 0.54]); for the secondary endpoints, there was a significant treatment change in respect of body weight (-3.7 vs. -0.2 kg [-5.5, -1.4; p = 0.001]), waist circumference (-3.1 vs. -0.8 cm [-4.2, -0.4; p = 0.019]), and heart rate (HR) (6.3 vs. -2.3 bpm [-3.0, 14.2; p = 0.003]), with no such treatment change in hemoglobin A1c levels (-11.0 vs. -9.2 mmol/mol [-7.0, 2.6; p = 0.37]), between groups. 18-week treatment of liraglutide compared with glimepiride did not improve LFRIdiastolic/systolic, but however increased HR. There was a significant treatment change in body weight reduction in favor for liraglutide treatment.
Highlights
Liraglutide is a glucagon-like peptide receptor agonist (GLP1RA) approved for the treatment of type 2 diabetes (T2D)
We aimed to investigate whether 18-week treatment of liraglutide, compared with glimepiride, could improve diastolic and or systolic longitudinal functional reserve index (LFRI), using stress exercise tissue Doppler echocardiography (TDE), in T2D patients with subclinical heart failure
105 patients were screened for eligibility, in which 62 met the criteria and were randomized to liraglutide or glimepiride
Summary
Liraglutide is a glucagon-like peptide receptor agonist (GLP1RA) approved for the treatment of type 2 diabetes (T2D). In the Liraglutide Effect and Action in Diabetes trial, which was launched to assess CV safety in T2D patients with high CV risk, treatment with liraglutide was compared with placebo [2]. The time-to-event analysis for the composite endpoint, i.e., the rate of the first occurrence of CV death, nonfatal myocardial infarction, or nonfatal stroke was significantly lower among T2D patients treated with liraglutide, compared with placebo. This effect was mainly driven by a significantly lower rate of CV death. The rates of nonfatal myocardial infarction, nonfatal stroke, and hospitalization of heart failure were, nonsignificantly lower in the liraglutide group than in the placebo group [2]
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