title: Inhibition of DPP-4 by alogliptin improves coronary flow reserve and left ventricular systolic function evaluated by phase contrast cine magnetic resonance imaging in patients with type 2 diabetes and coronary artery disease.
abstract: BACKGROUND
  The present study determined whether dipeptidyl peptidase-4 (DPP-4) inhibition by alogliptin improves coronary flow reserve (CFR) and left ventricular election fraction (LVEF) in patients with type 2 DM and CAD.
  
  
  METHODS
  Twenty patients with type 2 DM and known or suspected CAD were randomly allocated to receive diet therapy plus alogliptin (n=10; mean age, 73.3±6.6y) or a control group given diet therapy and glimepiride (n=10; mean age, 76.7±7.3y). Breath-hold PC cine MR images of the coronary sinus (CS) were acquired using a 1.5T MR scanner and 32 channel cardiac coils to assess blood flow of the CS at rest and during adenosine triphosphate (ATP) infusion. The CFR was calculated as CS blood flow during ATP infusion divided by that at rest. The CFR and LVEF were evaluated by MRI at baseline and at three months after starting therapy.
  
  
  RESULTS
  Hemoglobin A1c (HbA1c) was significantly reduced in both groups (alogliptin, 7.2±0.6% to 6.6±0.5%, p=0.034; control, 6.9±0.4% to 6.4±0.3%, p=0.008). However, CFR and LVEF significantly improved only in the alogliptin group (alogliptin: CFR, 2.15±0.61 to 2.85±0.80, p=0.042; LVEF, 59.4±6.3% to 68.0±8.6%, p=0.03; control: CFR, 2.17±0.37 to 2.38±0.32, p=0.19; LVEF, 58.2±9.1 to 60.3±8.8%, p=0.61). The % increases in CFR and in LVEF positively correlated (R=0.47 by Spearman's correlation coefficient; p=0.036).
  
  
  CONCLUSIONS
  The inhibition of DPP-4 by alogliptin improved CFR and LVEF evaluated by MRI in patients with type 2 DM and CAD and the improvement in CFR was associated with increased LV systolic function.
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan. Electronic address: shingo.m12226@gmail.com.
authors: Shingo
authors: S
authors: Kato
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Kazuki
authors: K
authors: Fukui
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Hidekuni
authors: H
authors: Kirigaya
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Daiki
authors: D
authors: Gyotoku
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Naoki
authors: N
authors: Iinuma
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Yuka
authors: Y
authors: Kusakawa
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Kohei
authors: K
authors: Iguchi
authors: Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Tatsuya
authors: T
authors: Nakachi
authors: Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
authors: Tae
authors: T
authors: Iwasawa
authors: Department of Cardiology, Yokohama City Medical Center, Japan.
authors: Kazuo
authors: K
authors: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D018819:Dipeptidyl Peptidase 4 / Q000502:physiology; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D010880:Piperidines / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D014498:Uracil / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D010880:Piperidines; D014498:Uracil; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4; C520853:alogliptin
keywords: Coronary flow reserve; DPP4 inhibitors; Diabetes mellitus; Magnetic resonance imaging