<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">A selective inhibitor of sodium-glucose cotransporter 2 (SGLT...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">A selective inhibitor of sodium-glucose cotransporter 2 (SGLT2), empagliflozin, has demonstrated its effects in reducing cardiovascular mortality and hospitalization rates for heart failure in type 2 diabetes patients. However, the cardiac-intrinsic mechanism for this cardiovascular benefit has not been sufficiently studied. We therefore aimed to investigate the effect of empagliflozin on left ventricular function in a group of patients with grade I hypertension. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We carried out a single-arm non-randomized clinical trial at the National Obesity Centre in Yaoundé over a period </span></span><span style="font-family:Verdana;">of </span><span style="font-family:Verdana;">8 months (October 2016 to May 2017), where patients were assigned to receive 25</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">mg of empagliflozin once daily. Cardiac ultrasound, 24</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">hour ambulatory blood pressure measurement, resting electrocardiography and biological assessment were carried out at baseline and at the end of a 6-week treatment period with empagliflozin. The primary outcome was the improvement of the left ventricular relaxation evaluation criteria. Ethical approval was obtained from the Centre Regional Ethics Committee in Yaoundé, Cameroon. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 11 patients were treated (median observation time, 6 weeks). We noted a non-significant improvement in the early lateral annular velocity from 9.7 [9.2</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">11.4] cm/s to 9.1 [8.8</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">10.2] cm/s, p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""></span><span style="font-family:Verdana;">0.21. We also noted a non-significant improvement of the mitral profile (E/A) from 0.71 [0.63</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.78] cm/s to 0.81 [0.58</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.88] cm/s,</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">= 0.08. There were no differences in E/E’ ratio, 5.0 [4.1</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">6.3] vs 5.6 [4.9</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">7.4], p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.07. There was a non-significant</span><span style="font-family:Verdana;"> drop in both systolic (p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.06) and diastolic (p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.09) blood pressure. We also observed on ECG a drop of the PR interval from 200 [157</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">- 200] ms to 160 [143</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">186] ms, p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.04. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Short-term treatment with empagliflozin does not show an improvement of the left ventricular function </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">in grade I hypertensive patients with diastolic dysfunction. </span><b><span style="font-family:Verdana;">Trial registration:</span></b><span style="font-family:Verdana;"> This </span></span><span style="font-family:Verdana;">study was retrospectively registered on Clinical Trial Registry with ClinicalTrials.gov Identifier: NCT04203914.</span>展开更多
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">A selective inhibitor of sodium-glucose cotransporter 2 (SGLT2), empagliflozin, has demonstrated its effects in reducing cardiovascular mortality and hospitalization rates for heart failure in type 2 diabetes patients. However, the cardiac-intrinsic mechanism for this cardiovascular benefit has not been sufficiently studied. We therefore aimed to investigate the effect of empagliflozin on left ventricular function in a group of patients with grade I hypertension. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We carried out a single-arm non-randomized clinical trial at the National Obesity Centre in Yaoundé over a period </span></span><span style="font-family:Verdana;">of </span><span style="font-family:Verdana;">8 months (October 2016 to May 2017), where patients were assigned to receive 25</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">mg of empagliflozin once daily. Cardiac ultrasound, 24</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">hour ambulatory blood pressure measurement, resting electrocardiography and biological assessment were carried out at baseline and at the end of a 6-week treatment period with empagliflozin. The primary outcome was the improvement of the left ventricular relaxation evaluation criteria. Ethical approval was obtained from the Centre Regional Ethics Committee in Yaoundé, Cameroon. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 11 patients were treated (median observation time, 6 weeks). We noted a non-significant improvement in the early lateral annular velocity from 9.7 [9.2</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">11.4] cm/s to 9.1 [8.8</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">10.2] cm/s, p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""></span><span style="font-family:Verdana;">0.21. We also noted a non-significant improvement of the mitral profile (E/A) from 0.71 [0.63</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.78] cm/s to 0.81 [0.58</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.88] cm/s,</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">= 0.08. There were no differences in E/E’ ratio, 5.0 [4.1</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">6.3] vs 5.6 [4.9</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">7.4], p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.07. There was a non-significant</span><span style="font-family:Verdana;"> drop in both systolic (p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.06) and diastolic (p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.09) blood pressure. We also observed on ECG a drop of the PR interval from 200 [157</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">- 200] ms to 160 [143</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">186] ms, p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">=</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.04. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Short-term treatment with empagliflozin does not show an improvement of the left ventricular function </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">in grade I hypertensive patients with diastolic dysfunction. </span><b><span style="font-family:Verdana;">Trial registration:</span></b><span style="font-family:Verdana;"> This </span></span><span style="font-family:Verdana;">study was retrospectively registered on Clinical Trial Registry with ClinicalTrials.gov Identifier: NCT04203914.</span>
