• Toshihiro Higashikawa, Tomohiko Ito, Takuro Mizuno, Keiichirou Ishigami, Kengo Kuroki, Takatoshi Haraguchi, Shinya Yamada, Ryusho Sangen, Jun Kiyosawa, Atsushi Saito, Masaharu Iguchi, Takeshi Nakahashi, Yuji Kasamaki, Akihiro Fukuda, Tsugiyasu Kanda, and Masashi Okuro.
• Kanazawa Medical University Himi Municipal Hospital, Kurakawa, Himi, Toyama, Japan.
• Medicine (Baltimore). 2024 Aug 9; 103 (32): e38948e38948.

AbstractPatients with type 2 diabetes mellitus are frequently hospitalized for heart failure. The ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e'), measured by echocardiography, is a simple and convenient indicator of diastolic dysfunction. Various large clinical trials have reported that sodium glucose transporter-2 inhibitor therapy reduced cardiovascular events and hospitalizations in heart failure patients. We examined the effect of tofogliflozin on various physiological and cardiac function. A retrospective analysis was performed on elderly patients aged 65 years or older with type 2 diabetes mellitus attending Himi Municipal Hospital who were taking oral tofogliflozin 20 mg/day. Measurement of physiological and hormonal variables, blood sampling, and echocardiographic evaluations at 0, 1, 3, and 6 months were performed on those with ejection fraction (EF) of 40% or greater at the time of treatment. Statistical analysis was performed using t-tests and mixed-effects models, with brain natriuretic peptide less than or not less than 100 pg/mL, estimated glomerular filtration rate (eGFR) less than or not less than 50 mL/min/1.73 m2, and diuretics administered or not. Hypoglycemic effects were observed at 0, 1, 3, and 6 months. At each time point, EF was retained and E/e' was significantly reduced. On the other hand, most physiological parameters and laboratory results showed no clinical abnormalities. Mixed-effects models showed time-dependent reduction of E/e' in high/low brain natriuretic peptide, high/low eGFR, with or without diuretics between baseline and at 6 months. The interaction with time was significant in high/low eGFR. Tofogliflozin was shown to improve E/e', a measure of diastolic function, while maintaining EF, with hypoglycemic effects and no clinical side effects.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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