Aim: Subclinical diastolic dysfuntion in patients with preclinical heart failure with preserved ejection fraction (HFpEF) has been demonstrated in patients with DM type 1. We investigated the relationship between diastolic dysfunction and NT-proBNP levels in patients with diabetes treated with iSGLT2 (dapagliflozin).

Methods: NT-proBNP and diastolic function were assessed in 35 patients with DM 1 (31 ± 1,6 y, duration of DM 12,0± 1,2 y) and 15 control subjects (mean age - 29,9± 1,8years) without clinical evidence of heart disease. Data presented as M±m. The results were compared using Student’s paired test.

Results: All patients had a normal ejection fraction (53,9±2,3 vs. 56,1± 4,3, (p > 0,05) in those with and without DM, respectively. 34,2% of the diabetic patients had evidence of diastolic dysfunction as assessed by the presence of at least two abnormal variables of mitral inflow velocity. The ratio of peak early to peak late (atrial) filling velocity was significantly decreased in diabetic compared with control subjects (E/A ratio 0,9±0,05 vs. 1,2± 0,06, p< 0,05), the DT was 257,1±28,2 ms vs. 186±14,6 ms p<0,05, in those with and without DM, respectively. Also, the IRT was increased in diabetic patients compared with control subjects (130±14,0 ms vs. 79,3±6,1 ms, p< 0,05). Median NT-proBNP plasma levels were elevated [189.54 pg/mL (86.16-308.27) and increased with greater severity of the diastolic dysfunction. Median NT-proBNP plasma levels have been decreased - 51.89 pg/mL (29.94-69.71); P<0.001] after 1 month treatment period with dapagliflozin.

Conclusions: DM type 1 patients presenting with normal ejection fraction show disturbed diastolic function and higher NT-proBNP levels. 2. iSGLT2 (dapagliflozin) decreased NT-proBNP levels in DM1 patients with subclinical diastolic dysfunction.


S. Cherviakova: None. L.K. Sokolova: None. I. Belchina: None. I. Korzun: None. M.D. Tronko: None.

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