title: Effects of the glucagon-like peptide-1 receptor agonist liraglutide on systolic function in patients with coronary artery disease and type 2 diabetes: a randomized double-blind placebo-controlled crossover study.
abstract: Patients with type 2 diabetes (T2D) and coronary artery disease (CAD) have increased risk of cardiac dysfunction. The diabetic heart is characterized by increased fatty acid oxidation and reduced glucose uptake resulting in reduced cardiac efficiency. Glucagon-like peptide-1 (GLP-1) has shown to increase myocardial glucose uptake and to improve myocardial function. We examined the effect of the GLP-1 receptor agonist, liraglutide, on the systolic function of the left ventricle (LV) in patients with T2D and stable CAD.
  
  
  
  In this placebo-controlled crossover study, 41 subjects with T2D and stable CAD were randomized to liraglutide or placebo and underwent dobutamine stress echocardiography (DSE) and exercise tolerance test at beginning and end of each intervention. The primary endpoint was changes in LV ejection fraction. Secondary endpoints were exercise capacity and other measures of systolic function: wall motion score index (WMSI), global longitudinal strain (GLS) and strain rate (GLSR).
  
  
  
  Liraglutide, when compared to placebo, did not improve LV ejection fraction at rest (+0.54 %; 95 % CI 2.38-3.45), at low stress (+0.03 %; 95 % CI 3.25-3.32), at peak stress (+1.12 %; 95 % CI 3.45-5.69), or at recovery (+4.06 %; 95 % CI 0.81-8.93). No significant changes in WMSI were observed at any stress levels. GLS and GLSR at rest did not improve. The maximal exercise capacity estimated by metabolic equivalents was not affected by liraglutide.
  
  
  
  In conclusion, liraglutide did not improve the systolic function of the left ventricle during DSE or the exercise capacity in patients with T2D and stable CAD. Clinical Trial Registration http://www.clinicaltrials.gov (unique identifier: NCT01595789).
authors.affiliation: Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark. preman.kumarathurai@dadlnet.dk.
authors.forename: Preman
authors.identifier: 0000-0002-2463-5110
authors.initials: P
authors.lastname: Kumarathurai
authors.affiliation: Department of Internal Medicine, Copenhagen University Hospital of Amager, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Anholm
authors.affiliation: Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
authors.forename: Olav W
authors.initials: OW
authors.lastname: Nielsen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
authors.forename: Ole P
authors.initials: OP
authors.lastname: Kristiansen
authors.affiliation: Department of Internal Medicine, Copenhagen University Hospital of Amager, Copenhagen, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Mølvig
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital of Hvidovre, Copenhagen, Denmark.
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
authors.affiliation: Department of Internal Medicine, Copenhagen University Hospital of Amager, Copenhagen, Denmark.|Clinical Research Center, Copenhagen University Hospital of Hvidovre, Copenhagen, Denmark.
authors.forename: Steen B
authors.initials: SB
authors.lastname: Haugaard
authors.affiliation: Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Sajadieh
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D004311:Double-Blind Method; D015444:Exercise / Q000502:physiology; D005260:Female; D000067757:Glucagon-Like Peptide-1 Receptor / Q000378:metabolism*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D000067757:Glucagon-Like Peptide-1 Receptor
keywords: Coronary artery disease; Diabetes mellitus; Dobutamine stress echocardiography; GLP-1; Left ventricular ejection fraction; Liraglutide