PDF(Pubmed)
Abstract：
Patients with type 2 diabetes mellitus are frequently hospitalized for heart failure. The ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e\'), measured by echocardiography, is a simple and convenient indicator of diastolic dysfunction. Various large clinical trials have reported that sodium glucose transporter-2 inhibitor therapy reduced cardiovascular events and hospitalizations in heart failure patients. We examined the effect of tofogliflozin on various physiological and cardiac function. A retrospective analysis was performed on elderly patients aged 65 years or older with type 2 diabetes mellitus attending Himi Municipal Hospital who were taking oral tofogliflozin 20 mg/day. Measurement of physiological and hormonal variables, blood sampling, and echocardiographic evaluations at 0, 1, 3, and 6 months were performed on those with ejection fraction (EF) of 40% or greater at the time of treatment. Statistical analysis was performed using t-tests and mixed-effects models, with brain natriuretic peptide less than or not less than 100 pg/mL, estimated glomerular filtration rate (eGFR) less than or not less than 50 mL/min/1.73 m2, and diuretics administered or not. Hypoglycemic effects were observed at 0, 1, 3, and 6 months. At each time point, EF was retained and E/e\' was significantly reduced. On the other hand, most physiological parameters and laboratory results showed no clinical abnormalities. Mixed-effects models showed time-dependent reduction of E/e\' in high/low brain natriuretic peptide, high/low eGFR, with or without diuretics between baseline and at 6 months. The interaction with time was significant in high/low eGFR. Tofogliflozin was shown to improve E/e\', a measure of diastolic function, while maintaining EF, with hypoglycemic effects and no clinical side effects.
摘要：
2型糖尿病患者经常因心力衰竭住院。舒张早期二尖瓣流入速度与舒张早期二尖瓣环速度之比(E/e'),通过超声心动图测量，是一种简单方便的舒张功能障碍指标。各种大型临床试验报道，钠葡萄糖转运蛋白2抑制剂治疗可减少心力衰竭患者的心血管事件和住院。我们检查了tofogliflozin对各种生理和心脏功能的影响。对在希米市立医院就诊的65岁或以上的2型糖尿病老年患者进行了回顾性分析，这些患者口服托福列净20mg/天。测量生理和激素变量，采血,在治疗时射血分数(EF)为40%或更高的患者,在0,1,3和6个月时进行超声心动图评估.使用t检验和混合效应模型进行统计分析，脑钠肽小于或不小于100pg/mL，估计肾小球滤过率（eGFR）小于或不小于50mL/min/1.73m2，以及是否施用利尿剂。在0、1、3和6个月观察到降血糖作用。在每个时间点,EF保留，E/e'显着降低。另一方面,大多数生理参数和实验室检查结果均无临床异常.混合效应模型显示高/低脑利钠肽的E/e'时间依赖性降低，高/低eGFR，基线和6个月之间有或没有利尿剂。在高/低eGFR中与时间的相互作用是显著的。Tofogliflozin被证明可以改善电子/电子，测量舒张功能,在保持EF的同时，具有降血糖作用，无临床副作用。
