Comparison of the Effects of Exenatide and Insulin Glargine on Right and Left Ventricular Myocardial Deformation as Shown by 2D-Speckle-Tracking Echocardiograms

Abstract

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<jats:title>Background:</jats:title>
<jats:p>Exenatide is a glucagon-like peptide-1 (GLP-1) analogs. The effects of GLP-1 analogs on myocardial function are controversial.</jats:p>
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<jats:title>Aims:</jats:title>
<jats:p>The purpose of this study is to compare the effects of exenatide and insulin glargine on subclinical right and left ventricular dysfunction.</jats:p>
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<jats:title>Methods and Material:</jats:title>
<jats:p>In this study, 27 patients with type 2 diabetes were randomized into exenatide and insulin glargine treatment groups. The patients were monitored for six months by conventional echocardiography (ECHO) and 2D-speckle-tracking echocardiography (2D-STE) to evaluate right and left ventricular functions.</jats:p>
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<jats:title>Results:</jats:title>
<jats:p>ECHO parameters did not change significantly pre- and post-treatment, except for the tricuspid annular plane systolic excursion (TAPSE) values. Post-treatment TAPSE values significantly increased in both groups compared to pre-treatment values. In the insulin group, values for 2D-STE parameters of the left ventricular global longitudinal strain (LVGLS) based on apical long-axis (ALA) images increased significantly (p: 0.047) compared to pre-treatment values; however, apical 4-chamber (A4C), apical 2-chamber (A2C), LVGLS, and right ventricular global longitudinal strain (RVGLS) values did not change. In the exenatide group, LVGLS based on A4C values improved (p: 0.048), while ALA, A2C, and LVGLS values did not change. Moreover, the RVGLS values improved significantly after exenatide treatment (p: 0.002). Based on 2D-STE parameters the two treatments did not differ statistically in either pre- or post-treatment periods.</jats:p>
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<jats:title>Conclusions:</jats:title>
<jats:p>Glp-1 treatment can improve left ventricular regional and right ventricular global subclinical dysfunction. Therefore, early GLP-1 treatment may be recommended in diabetic patients with a high risk of cardiac dysfunction.</jats:p>
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