Association of type 2 diabetes mellitus with the development of new-onset atrial fibrillation in patients with non-ischemic dilated cardiomyopathy: impact of SGLT2 inhibitors
Association of type 2 diabetes mellitus with the development of new-onset atrial fibrillation in patients with non-ischemic dilated cardiomyopathy: impact of SGLT2 inhibitors
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DOI：
10.1007/s10554-020-02122-x
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发表时间：
2021-01
期刊：
影响因子：
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通讯作者：
Hidekazu Tanaka;Kazuhiro Tatsumi;Hiroki Matsuzoe;Fumitaka Soga;Kensuke Matsumoto;K. Hirata
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文献类型：
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作者：
Hidekazu Tanaka;Kazuhiro Tatsumi;Hiroki Matsuzoe;Fumitaka Soga;Kensuke Matsumoto;K. Hirata
摘要本研究旨在探讨2型糖尿病(T2 DM)与非缺血性扩张型心肌病(DCM)患者新发心房颤动(AF)的关系。我们还验证了葡萄糖协同转运体2型(SGLT2)抑制剂可降低非缺血型扩张型心肌病患者发生新发房颤的风险的假设。我们回顾研究了210例非缺血型扩张型心肌病伴窦性心律患者，平均年龄59.0 ± 16.7岁，左心室射血分数31.0 ± 8.2%(ALL<； 45%)。60例患者(28.6%)确诊为T2 DM，其余150例(71.4%)为非T2 DM患者，21例(10.0%)发生新发房颤，平均随访时间为6.1年。Kaplan-Meier曲线分析显示，与T2 DM患者相比，无T2 DM的非缺血性扩张型心肌病患者发生新发房颤的几率较低(对数等级p = ，0.0003)。此外，新发房颤患者的整体纵向应变显著低于窦性心律保持者(6.4 ± 1.4%vs.7.7 ± 2.2%，p = 0.01)。在60例非缺血性扩张型心肌病合并T2 DM患者中，接受SGLT2抑制剂治疗的患者发生新发房颤的几率低于未接受SGLT2抑制剂治疗的患者(对数列p = 0.040)。在非缺血性DCM患者中，T2 DM与新发房颤的发生相关，使用SGLT2抑制剂治疗可以显著减少新发房颤的发生。因此，我们的发现可能为T2 DM非缺血型DCM患者的治疗提供新的视角。
AbstractThe aim of this study was to investigate the association of type 2 diabetes mellitus (T2DM) with the development of new-onset atrial fibrillation (AF) for non-ischemic dilated cardiomyopathy (DCM) patients. We also tested the hypothesis that sodium glucose cotransporter type 2 (SGLT2) inhibitors reduce the risk of development of new-onset AF for non-ischemic DCM patients. We retrospectively studied 210 patients with non-ischemic DCM and sinus rhythm, mean age of 59.0 ± 16.7 years and left ventricular ejection fraction of 31.0 ± 8.2% (all < 45%). T2DM was identified in 60 patients (28.6%), and the remaining 150 patients (71.4%) were classified as non-T2DM patients. New-onset AF occurred in 21 patients (10.0%) over a median follow-up of 6.1 years. Kaplan–Meier curve analysis showed that non-ischemic DCM patients without T2DM experienced fewer occurrences of the development of new-onset AF compared with those with T2DM (log-rank p = 0.0003). Furthermore, global longitudinal strain in patients who showed development of new-onset AF was significantly lower than that in those whose sinus rhythm was preserved (6.4 ± 1.4% vs. 7.7 ± 2.2%, p = 0.01). Of the 60 non-ischemic DCM patients with T2DM, those treated with SGLT2 inhibitors experienced fewer occurrences of the development of new-onset AF than did those not treated with SGLT2 inhibitors (log-rank p = 0.040). T2DM is associated with the development of new-onset AF in non-ischemic DCM patients, and treatment with SGLT2 inhibitors can significantly reduce the development of new-onset AF. Our findings may thus offer a new insight into the management of non-ischemic DCM patients with T2DM.