The Effect Of Sodium-glucose co-transporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists Or Their Combination On Key Cardiac Magnetic Resonance Markers
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP1-RA) have significantly improved the management of type 2 diabetes (T2D), particularly for patients at high risk for cardiovascular and renal outcomes. Both treatments have been shown to reduce multiple laboratory and image-derived markers, revealing their mechanisms behind their impact on clinical outcomes. In the EMPA-HEART trial, the empagliflozin treatment led to a significant decrease in indexed left ventricular mass, while the liraglutide treatment reduced early LV diastolic filling and pressures. However, there is limited evidence exists regarding the combined effect of these treatments. A recent metanalysis of the HARMONY and AMPLITUDE-O trials indicated that the GLP1-RA treatment reduced cardiovascular events regardless of the background SGLT2i treatment, suggesting a potential additive effect in cardiovascular risk reduction with their combination.
The objective of this study is to compare the impact of SGLT2i and GLP1-RA, whether administered alone or in combination, on key CMR markers (indexed LV mass, LV end-diastolic and end-systolic volumes) in a group of T2D patients.