A Study of Diastolic Dysfunction in Patients of Type-2 Diabetes Mellitus in Rural Population of Western Uttar Pradesh

Kumar, Manoj; Gautham, Rajesh Kumar; Singh, Pradyumn; Kumar, Granth; Kant, Priyesh; Sharma, Himanshu; Pious, Tony; Yadav, Sudhir Kumar

doi:10.18410/jebmh/2017/314

Cited by 3 publications

(4 citation statements)

References 55 publications

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“…[7] Also, the prevalence of hospitalizations due to HFpEF comparative to heart failure with reduced ejection fraction (HFrEF) is increasing at a rate of 1% per year. [5]…”

Section: Epidemiologymentioning

confidence: 99%

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Review on sodium-glucose cotransporter 2 inhibitor (SGLT2i) in diabetes mellitus and heart failure

Pradhan

Vohra

Vishwakarma

et al. 2019

J Family Med Prim Care

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SGLT-2 inhibitors are a novel class of anti-diabetic agents which act by inhibiting glucose reabsorption in proximal convoluted tubules of kidney. Apart from maintaining glucose homeostasis they exert a number of positive effects on the cardiovascular system like weight loss, decreasing blood pressure, preserving renal function, reducing triglycerides, natriuresis and improving endothelial dysfunction. In large clinical trials, all the three prototype agents – Empaglifozin, Canaglifozin and dapaglifozin have shown reductions in major adverse cardiovascular events including cardiovascular deaths, non fatal MI, stroke and heart failure (HF) hospitalizations. The reduction in heart failure hospitalization is a surprising finding and trials of these drug are now underway for HF also. More surprising is the fact that the benefits are comparable or even better that achieved by recently approved novel drugs for HF. In this review, we briefly discuss the pathophysiology of HF in diabetes, describe the prototype SGLT-2 molecules available, their data from large cardiovascular outcome trials till date and their role in current practice of diabetes management.

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“…[7] Also, the prevalence of hospitalizations due to HFpEF comparative to heart failure with reduced ejection fraction (HFrEF) is increasing at a rate of 1% per year. [5]…”

Section: Epidemiologymentioning

confidence: 99%

“…[4] It is known that approximately, 50% cases of DM suffer from heart failure with preserved ejection fraction (HFpEF). [5] Therefore, DM has been perceived as a responsible factor for HF.…”

Section: Introductionmentioning

confidence: 99%

Review on sodium-glucose cotransporter 2 inhibitor (SGLT2i) in diabetes mellitus and heart failure

Pradhan

Vohra

Vishwakarma

et al. 2019

J Family Med Prim Care

View full text Add to dashboard Cite

show abstract

“…The Framingham study showed that the development of HF is two times more likely in men with diabetes and five times more likely in women with diabetes after adjustment for other risk factors, including age, coronary heart disease, and hypertension [2]. It is also known that approximately 50% of cases of diabetes mellitus (DM) suffer from HF with preserved ejection fraction (HFpEF) [3]. Therefore, DM has been perceived as a factor responsible for HF.…”

Section: Introductionmentioning

confidence: 99%

Anti-Diabetic Therapy and Heart Failure: Recent Advances in Clinical Evidence and Molecular Mechanism

Hsu

Hsuan

Liao

et al. 2023

Life

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Diabetic patients have a two- to four-fold increase in the risk of heart failure (HF), and the co-existence of diabetes and HF is associated with poor prognosis. In randomized clinical trials (RCTs), compelling evidence has demonstrated the beneficial effects of sodium-glucose co-transporter-2 inhibitors on HF. The mechanism includes increased glucosuria, restored tubular glomerular feedback with attenuated renin–angiotensin II–aldosterone activation, improved energy utilization, decreased sympathetic tone, improved mitochondria calcium homeostasis, enhanced autophagy, and reduced cardiac inflammation, oxidative stress, and fibrosis. The RCTs demonstrated a neutral effect of the glucagon-like peptide receptor agonist on HF despite its weight-reducing effect, probably due to it possibly increasing the heart rate via increasing cyclic adenosine monophosphate (cAMP). Observational studies supported the markedly beneficial effects of bariatric and metabolic surgery on HF despite no current supporting evidence from RCTs. Bromocriptine can be used to treat peripartum cardiomyopathy by reducing the harmful cleaved prolactin fragments during late pregnancy. Preclinical studies suggest the possible beneficial effect of imeglimin on HF through improving mitochondrial function, but further clinical evidence is needed. Although abundant preclinical and observational studies support the beneficial effects of metformin on HF, there is limited evidence from RCTs. Thiazolidinediones increase the risk of hospitalized HF through increasing renal tubular sodium reabsorption mediated via both the genomic and non-genomic action of PPARγ. RCTs suggest that dipeptidyl peptidase-4 inhibitors, including saxagliptin and possibly alogliptin, may increase the risk of hospitalized HF, probably owing to increased circulating vasoactive peptides, which impair endothelial function, activate sympathetic tones, and cause cardiac remodeling. Observational studies and RCTs have demonstrated the neutral effects of insulin, sulfonylureas, an alpha-glucosidase inhibitor, and lifestyle interventions on HF in diabetic patients.

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“…[5][6][7] Hyperglycemia is an independent risk factor for ischemic heart disease (IHD) as several mechanisms lead to vascular damage due to long-term hyperglycemia. 8,9 To clarify the mechanisms responsible for decreased myocardial contractility in the diabetic population, several explanations have been proposed. 10,11 In patients with diabetes, altered metabolism has been associated with increased myocardial oxygen consumption and increased serum free fatty acid (FFA) concentrations.…”

Section: Introductionmentioning

confidence: 99%

Glyphozines and treatment of cardiac disease

Ferrara

Granata

Pelliccia³

et al. 2020

Geriatr Care

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Glyphozines also called SGLT2 inhibitors, are a new class of agents that inhibit reabsorption of glucose in the kidney, in proximal tubules, and therefore lower blood sugar. They act by inhibiting sodiumglucose transport protein 2 (SGLT2). Glyphozines are used in the treatment of type II diabetes mellitus. In studies with canagliflozin, a member of this class, the medication was found to enhance blood sugar control as well as reduce body weight and systolic and diastolic blood pressure. In addition to regulate blood glucose, recent studies have shown that glyphozines have important positive cardiovascular benefits, such as weight loss, decreased volaemia and PA, reduced triglycerides, natriuresis and improved endothelial wall dysfunction. Clinical studies have shown reduction in deaths from cardiovascular events among diabetic patients treated with glyphozines. At the moment these drugs are being studied for an extension of the therapeutic indication also for cardiovascular diseases such as heart failure. In this review, we discuss the class of SGLT2 inhibitors in the treatment of diabetes, and studies focused on their possible role in the treatment of cardiac disease.

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A Study of Diastolic Dysfunction in Patients of Type-2 Diabetes Mellitus in Rural Population of Western Uttar Pradesh

Cited by 3 publications

References 55 publications

Review on sodium-glucose cotransporter 2 inhibitor (SGLT2i) in diabetes mellitus and heart failure

Review on sodium-glucose cotransporter 2 inhibitor (SGLT2i) in diabetes mellitus and heart failure

Anti-Diabetic Therapy and Heart Failure: Recent Advances in Clinical Evidence and Molecular Mechanism

Glyphozines and treatment of cardiac disease

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