| ObjectiveThis study focused on the effects of dapagliflozin,a sodium-glucose cotransporter2 inhibitor(SGLT2 inhibitor),on heart function in patients with type 2 diabetes mellitus(T2DM)combined with heart failure with preserved ejection fraction(HFp EF).The effect of dapagliflozin on cardiac function in patients with type 2 diabetes mellitus(T2DM)combined with preserved ejection fraction(HFp EF)provides data to support the treatment of patients with type 2 diabetes mellitus combined with preserved ejection fraction heart failure.MethodsIn this prospective randomized single-blind controlled study,60 patients diagnosed with T2 DM combined with HFp EF in a hospital from May 2021 to May2022 were selected as the study subjects,and the fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),body mass index(BMI),blood pressure(BP),and N-terminal pro-B-type natriuretic peptide(NTP)were measured in all patients.(Hb A1c),body mass index(BMI),blood pressure(BP),N-terminal pro-B-type natriuretic peptide(NT-pro BNP),left ventricular ejection fraction(Left ventricular ejection fraction(LVEF),structural cardiac parameters(left atrial diameter(LAD),inter ventricular septal thickness(IVST),left ventricular end diastolic diameter(LVD),and left ventricular end diastolic diameter(LVED)).Left ventricular end diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT))and other parameters,and were divided into two groups using the random number table method:the experimental group(30 cases)and the control group(30 cases).Both groups were treated with conventional glucose-lowering drugs(metformin,acarbose,insulin)and anti-heart failure drugs(ACEI/ARB/vasodilator/β-blockers)on the basis of health education,and the experimental group was treated with dapagliflozin 10 mg/day on top of conventional glucose-lowering drugs.After 6 months of treatment,FBG,Hb A1 c,BP,BMI,NT-pro BNP and structural indices related to cardiac ultrasound: LVEF,LAD,IVST,LVEDD,LVPWT were compared between the two groups,and the obtained data were statistically processed and analyzed.Results1.Comparison of the general conditions of patients in the two groups before and after treatmentBefore treatment: There was no statistically significant difference between the age,gender,BMI,BP,NYHA classification,and medication use of the two groups(P>0.05).After treatment:(1)comparison of age,gender,BMI,NYHA classification and medication in the two groups,the difference was not statistically significant(P>0.05);(2)BP: compared with the control group,BP decreased after 6 months of treatment in the experimental group,and the difference was statistically significant(P<0.05).2.Comparison of blood glucose levels before and after treatment between the two groups of patientsBefore treatment: There was no statistically significant difference between the FBG and Hb A1 c of the two groups(P>0.05).After treatment:(1)there was no statistically significant difference between the FBG of patients in the two groups(P>0.05);(2)compared with the control group,the Hb A1 c of the experimental group decreased after 6 months of treatment,and the difference was statistically significant(P<0.05).3.Comparison of cardiac function indexes before and after treatment between two groups of patientsNT-proBNP: Before treatment: the difference of NT-proBNP between the two groups was not statistically significant(P>0.05).After treatment: compared with the control group,NT-pro BNP decreased significantly in the experimental group,and the difference was statistically significant(P < 0.05).LVEF: Before treatment: there was no statistically significant difference in LVEF between the two groups(P>0.05).After treatment: there was no statistically significant difference in LVEF between the two groups of patients(P>0.05).4.Comparison of cardiac structural parameters between the two groups of patients before and after treatmentBefore treatment: there was no statistically significant difference in LAD,IVST,LVEDD and LVPWT between the two groups(P>0.05).After treatment: compared with the control group,the LAD and LVEDD decreased after 6 months of treatment in the experimental group,and the difference was statistically significant(P < 0.05);after6 months of treatment,there was no significant change in IVST and LVPWT in the experimental group compared with the control group,and the difference was not statistically significant(P > 0.05).ConclusionDapagliflozin can effectively reduce the levels of Hb A1 c,BP and NT-pro BNP in patients with T2 DM combined with HFp EF,and improve the levels of LAD and LVEDD,the structural parameters of the heart,and play a role in improving cardiac function.However,no significant improvement in LVEF was observed in patients with T2 DM combined with HFp EF,and long-term follow-up is needed. |
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