The Effect of Sodium-Glucose Cotransporter-2 Inhibitors on Atrial Electromechanic Conduction Time

OBJECTIVE
The frequency of atrial fibrillation (AF) in patients with diabetes has been shown to be significantly higher than in the general population. Atrial electromechanical delay is known as an important determinant of atrial fibrillation. In this study, it is aimed to investigate the effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors, which are relatively new oral antidiabetic drugs, on atrial electromechanical delay (EMD) time in patients with type 2 diabetes mellitus (DM).


METHOD
Thirty type 2 DM patients (53.3% female, mean age 60.07±10.03 years),who were going to start SGLT-2 inhibitor were included in the study. The patients were evaluated with echocardiography at baseline and 6 months later. Basic echocardiographic findings and atrial electromechanical delay times were calculated with tissue Doppler.


RESULTS
While no significant decrease was observed in intra-atrial EMD times, a significant shortening was observed in interatrial EMD times. It was found that interatrial EMD times, which were 15.13±5.87 ms, decreased to 13.20±6.12 ms in the control (p=0.029). In lateral PA times (58.73±6.41 ms to 54.37±6.97 ms, p<0.001), septal PA times (50.90±6.02 ms to 48.23±5, Statistically significant shortenings were observed in the duration of the tricuspid PA (from 43.60±6.28 ms to 41.30±5.60 ms, p=0.003). There was a significant decrease in e/e' values from 8.13±4.0 to 6.50±2.37 (p=0.003)


CONCLUSION
SGLT-2 inhibitors might have curative effects on electromechanical conduction of the atrium and thus protect from DM-related functional impairment and arrhythmia, particularly AF.