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

BACKGROUND:

The 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.

PURPOSE:

To assess the effects of liraglutide on left ventricular (LV) diastolic and systolic function in South Asian type 2 diabetes patients.

STUDY TYPE:

Prospective, double-blind, randomized, placebo-controlled trial.

POPULATION:

Forty-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/SEQUENCE:

3T (balanced steady-state free precession cine MRI, 2D and 4D velocity-encoded MRI, 1 H-MRS, T1 mapping).

ASSESSMENT:

Primary 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 TESTS:

Data 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).

RESULTS:

Liraglutide (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 CONCLUSION:

Liraglutide 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: 4 J. Magn. Reson. Imaging 2020;51:1679-1688.

• Authors: Elisabeth H M Paiman, Huub J van Eyk, Minke M A van Aalst, Maurice B Bizino, Rob J van der Geest, Jos J M Westenberg, Petronella H Geelhoed-Duijvestijn, Aan V Kharagjitsingh, Patrick C N Rensen, Johannes W A Smit, Ingrid M Jazet, Hildo J Lamb
• Journal: Journal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 51 Issue 6 Pg. 1679-1688 (06 2020) ISSN: 1522-2586 [Electronic] United States
• PMID: 31799782 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

Chemical References

• Liraglutide

Topics

• Diabetes Mellitus, Type 2 (drug therapy)
• Double-Blind Method
• Humans
• Liraglutide (therapeutic use)
• Netherlands
• Prospective Studies
• Pulse Wave Analysis