Effect of semaglutide on global longitudinal strain and global myocardial work efficiency in patients with uncontrolled type 2 diabetes mellitus and obesity

Abstract

Introduction: Cardiovascular outcome trials (CVOTs) demonstrated that GLP1-RAs have effectively reduced CV risk in T2DM patients, so their use is recommended by guidelines Aim: The objective of our work is to evaluate the effect of Semaglutide, in a cohort of uncontrolled diabetic patients, on oxidative stress, platelet activation and myocardial deformation and efficiency parameters, obtained by speckle tracking echocardiography (STE). Materials and Methods: We enrolled 70 patients with T2DM and obesity. All clinical evaluation and laboratory tests were performed at baseline and after 6 months of treatment. Results: At follow-up, data showed significant improvement in heart rate, NT-ProBNP and metabolic parameters. Moreover, there was an improvement in creatinine and eGFR, a significant reduction in oxidative stress biomarkers such as 8-isoprostane (p<0.0001), Nox-2 (p<0.0001), and platelet activation such as sP-selectin (p<0.0001). We observed a significant improvement in left ventricular myocardial deformation parameters such as GLS (p<0.0001), GLS endo/epi (p<0.0001) and GWE (p<0.0001). The linear correlation analysis showed that GLS endo-epi was inversely correlated with HOMA (p=0.001), uric acid (p=0.012), Nox-2 (p=0.016), Sp-selectin (p=0.010); GLS was inversely correlated with HOMA (p=0.011), uric acid (p=0.025) and Sp-selectin (p<0.0001); GWE was inversely correlated with HOMA (p=0.011), uric acid (p=0.025) and Spselectin (p<0.0001). From stepwise multivariate linear regression model, Sp-selectin, uric acid and HOMA justifying 27.8%, 4.4% and 5.6% of GLS variation. Conclusion: Our results demonstrated that 6 months treatment with Semaglutide, improved GLS, GLS endo-epi ratio and GWE, due to reduced levels of oxidative stress, platelet activation, probably acting on the microcirculation.