Abstract：
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors have been shown to reduce the risk of atrial fibrillation (AF) occurrence in patients with diabetes mellitus (DM). In this prospective study, we aimed to analyze the effect of SGLT-2 inhibitors as an add-on therapy to metformin on P wave indices and atrial electromechanics in patients with type 2 DM.
A total of 144 patients enrolled. Electrocardiographic indices were recorded on admission and at 3rd and 6th month of the combination therapy. P wave indices and atrial electromechanical coupling intervals were measured and compared.
Although decrease in P wave dispersion (62.78 ± 9.59 vs. 53.62 ± 10.65; p = .002) became significant at 6th month of combination therapy, significant decreases in P wave terminal force in V1 (37.79 ± 3.45 vs. 32.01 ± 5.74; p = .035), left atrial volume index (35.87 ± 6.57 vs. 31.33 ± 7.31; p = .042), left sided intra-atrial electromechanical delay (32.09 ± 9.17 vs. 27.61 ± 8.50; p = .016), right sided intra-atrial electromechanical delay (31.82 ± 4.92 vs. 27.65 ± 8.05; p = .042), and interatrial electromechanical delay (29.65 ± 7.52 vs. 25.96 ± 4.30; p = .044) were seen as early as 3rd month of treatment. Besides, there was no statistically significant difference between Empagliflozin and Dapagliflozin subgroups in terms of mentioned parameters.
SGLT-2 inhibitors as an add-on therapy to metformin were shown to significantly improve P wave indices and atrial electromechanics in type 2 DM patients as early as the 3rd month of treatment. It was thought that this may be one of the underlying mechanisms of the decrease in the frequency of AF with the use of SGLT2 inhibitors.
A total of 144 patients enrolled. Electrocardiographic indices were recorded on admission and at 3rd and 6th month of the combination therapy. P wave indices and atrial electromechanical coupling intervals were measured and compared.
Although decrease in P wave dispersion (62.78 ± 9.59 vs. 53.62 ± 10.65; p = .002) became significant at 6th month of combination therapy, significant decreases in P wave terminal force in V1 (37.79 ± 3.45 vs. 32.01 ± 5.74; p = .035), left atrial volume index (35.87 ± 6.57 vs. 31.33 ± 7.31; p = .042), left sided intra-atrial electromechanical delay (32.09 ± 9.17 vs. 27.61 ± 8.50; p = .016), right sided intra-atrial electromechanical delay (31.82 ± 4.92 vs. 27.65 ± 8.05; p = .042), and interatrial electromechanical delay (29.65 ± 7.52 vs. 25.96 ± 4.30; p = .044) were seen as early as 3rd month of treatment. Besides, there was no statistically significant difference between Empagliflozin and Dapagliflozin subgroups in terms of mentioned parameters.
SGLT-2 inhibitors as an add-on therapy to metformin were shown to significantly improve P wave indices and atrial electromechanics in type 2 DM patients as early as the 3rd month of treatment. It was thought that this may be one of the underlying mechanisms of the decrease in the frequency of AF with the use of SGLT2 inhibitors.
摘要：
背景：钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂已被证明可降低糖尿病（DM）患者发生房颤（AF）的风险。在这项前瞻性研究中，我们旨在分析SGLT-2抑制剂作为二甲双胍的附加治疗对2型DM患者P波指数和心房电力学的影响.
方法：共纳入144例患者。在入院时以及联合治疗的第3个月和第6个月记录心电图指标。测量并比较P波指数和心房机电耦合间隔。
结果：尽管P波离散度降低（62.78±9.59vs.53.62±10.65；p=.002）在联合治疗的第6个月变得显着，V1中P波终端力显著下降(37.79±3.45vs.32.01±5.74；p=.035），左心房容积指数(35.87±6.57vs.31.33±7.31；p=.042），左侧心房内机电延迟(32.09±9.17vs.27.61±8.50；p=.016），右侧心房内机电延迟(31.82±4.92vs.27.65±8.05；p=.042），和房间电机械延迟(29.65±7.52vs.25.96±4.30；p=.044）早在治疗的第3个月就观察到。此外,在上述参数方面,Empagliflozin和Dapagliflozin亚组之间无统计学差异.
结论：SGLT-2抑制剂作为二甲双胍的附加疗法，早在治疗的第3个月就能显著改善2型DM患者的P波指数和心房电力学。认为这可能是使用SGLT2抑制剂降低AF频率的潜在机制之一。
方法：共纳入144例患者。在入院时以及联合治疗的第3个月和第6个月记录心电图指标。测量并比较P波指数和心房机电耦合间隔。
结果：尽管P波离散度降低（62.78±9.59vs.53.62±10.65；p=.002）在联合治疗的第6个月变得显着，V1中P波终端力显著下降(37.79±3.45vs.32.01±5.74；p=.035），左心房容积指数(35.87±6.57vs.31.33±7.31；p=.042），左侧心房内机电延迟(32.09±9.17vs.27.61±8.50；p=.016），右侧心房内机电延迟(31.82±4.92vs.27.65±8.05；p=.042），和房间电机械延迟(29.65±7.52vs.25.96±4.30；p=.044）早在治疗的第3个月就观察到。此外,在上述参数方面,Empagliflozin和Dapagliflozin亚组之间无统计学差异.
结论：SGLT-2抑制剂作为二甲双胍的附加疗法，早在治疗的第3个月就能显著改善2型DM患者的P波指数和心房电力学。认为这可能是使用SGLT2抑制剂降低AF频率的潜在机制之一。
