The Effects of SGLTi on Diabetic Cardiomyopathy (SGLTi)
The Effects of SGLT Inhibition on Diabetic Cardiomyopathy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Diabetic cardiomyopathy is defined as ventricular dysfunction in diabetic patients in the absence of coronary artery disease and hypertension. It is considered as a cardiac muscle disorder due to the metabolic consequences of DM characterized by left ventricular hypertrophy, left ventricular diastolic dysfunction (in the early stage), and/or systolic dysfunction. To date, there is no specific treatment proven effective for the condition due to the incomplete understanding of the pathogenesis.
Recent studies however prove the efficacy of SGLT-2 inhibitors on reducing the primary composite end point of cardiovascular outcomes including hospitalization for heart failure, cardiovascular death, and all-cause death amongst patients with type II DM. Such clinical benefit is apparently mainly stemmed from the reduction in heart failure related mortality and sudden cardiac death rather than the macro-vascular events such as myocardial infarct and stroke, suggesting addition benefits going beyond the correction of hyperglycemia perse. These studies thus raise the possibility that the drug may have direct effects on the myocardium that conferring the clinical benefit not related the modification of traditional risk factors such as glycemic control, lipid, blood pressure, and obesity.
A single-arm, observational cardiac magnetic resonance imaging study is proposed in type II diabetic patients before and 2 months after initiation of dapagliflozin. The aim is to identify mechanistic insights leading to the unexpected clinical benefit of SGLT inhibition.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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-
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Hong Kong, Hong Kong
- Queen Mary Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- type 2 diabetes
- 40-90 years old
- HbA1c >= 6.5%
- history of heart failure with reduced ejection fraction
- indications for SGLT inhibition on clinical ground
Exclusion Criteria:
- angina pectoris or chest discomfort
- prior coronary artery bypass grafts
- coronary artery stenting within 6 months of study enrolment
- pervious myocardial infarct
- any contraindication for stress CMR testing
- renal impairment with eGFR <45ml/min/1.73m2
- limited life expectancy <5 years, for example due to pulmonary disease, cancer or
- significant hepatic failure
- contraindication to dapagliflozin or other SGLT2 inhibitors
- unable to take dapagliflozin
- patients currently on and SGLT2 inhibitor
- planned need for concomitant cardiac surgery or coronary intervention
- refusal or inability to sign an informed consent
- potential for on-compliance towards the requirements in the trial protocol (especially the medical treatment) or follow-up visits
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Dapagliflozin
Dapagliflozin, one of the SGLT-2 inhibitors, will be prescribed to DM patients on clinical ground
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Dapagliflozin, one of the SGLT-2 inhibitors, will be prescribed to DM patients on clinical ground.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in myocardial perfusion reserve index
Time Frame: 8-12 weeks
|
Change in myocardial perfusion reserve index calculated from cardiac MRI
|
8-12 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: David Chung-Wah SIU, Prof, The University of Hong Kong
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Endocrine System Diseases
- Diabetes Complications
- Diabetes Mellitus
- Cardiomyopathies
- Diabetic Cardiomyopathies
- Hypoglycemic Agents
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Sodium-Glucose Transporter 2 Inhibitors
- Dapagliflozin
Other Study ID Numbers
Other Study ID Numbers
- Version no.3
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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