Liraglutide improves cardiac function in patients with type 2 diabetes and chronic heart failure.
OBJECTIVE
To compare the effect of liraglutide, sitagliptin and insulin glargine added to standard therapy on left ventricular function in post-ischemic type-2 diabetes mellitus patients.


METHODS
We evaluated 32 type-2 diabetes mellitus Caucasians with history of post-ischemic chronic heart failure NYHA class II/III and/or left ventricular ejection fraction ≤45 %. Participants underwent laboratory determinations, electrocardiogram, echocardiogram, Minnesota Living with Heart Failure questionnaire and 6 min walking test at baseline and following 52 weeks treatment. Patients were treated with standard therapy for chronic heart failure and were randomized to receive liraglutide, sitagliptin and glargine in addition to metformin and/or sulfonylurea.


RESULTS
Liraglutide treatment induced an improvement in left ventricular ejection fraction from 41.5 ± 2.2 to 46.3 ± 3 %; P = 0.001). On the contrary, treatment with sitagliptin and glargine induced no changes in left ventricular ejection fraction (41.8 ± 2.6 vs. 42.5 ± 2.5 % and 42 ± 1.5 vs. 42 ± 1.6 %, respectively; P = NS). Indexed end-systolic LV volume was reduced only in liraglutide-treated patients (51 ± 9 vs. 43 ± 8 ml/m2; P < 0.05). Liraglutide treatment induced also a significant increase in the anterograde stroke volume (39 ± 9 vs. 49 ± 11 ml; P < 0.05), whereas no differences were observed in the other two groups. Cardiac output and cardiac index showed a significant increase only in liraglutide-treated patients (4.4 ± 0.5 vs. 5.0 ± 0.6 L/min; P < 0.05 and 1.23 ± 0.26 vs. 1.62 ± 0.29 L/m2; P = 0.005, respectively). Liraglutide treatment was also associated with an improvement of functional capacity and an improvement of quality of life.


CONCLUSIONS
These data provide evidence that treatment with liraglutide is associated with improvement of cardiac function and functional capacity in failing post-ischemic type-2 diabetes mellitus patients.
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy.
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Arturi
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy.
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Succurro
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy.
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Miceli
Unit of Cardiology "S.S. Annunziata" Hospital of Cosenza, Cosenza, Italy.
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Cloro
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy.
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Ruffo
Azienda Ospedaliera Mater Domini, Catanzaro, Italy.
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Maio
Department of Clinical and Experimental Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.
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Perticone
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy.
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Sesti
Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy. perticone@unicz.it.
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Perticone
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002316:Cardiotonic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D054795:Incretins / Q000009:adverse effects / Q000627:therapeutic use; D000069036:Insulin Glargine / Q000009:adverse effects / Q000627:therapeutic use; D000069450:Liraglutide / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D000068900:Sitagliptin Phosphate / Q000009:adverse effects / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology
D015415:Biomarkers; D002316:Cardiotonic Agents; D007004:Hypoglycemic Agents; D054795:Incretins; D013453:Sulfonylurea Compounds; D000069036:Insulin Glargine; D000069450:Liraglutide; D008687:Metformin; D000068900:Sitagliptin Phosphate
Cardiac function; Chronic heart failure; Glucagon-like peptide-1; Left ventricular ejection fraction; Liraglutide; Type 2 diabetes