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EFFECT OF EMPAGLIFLOZIN ON HR VARIABILITY AND QT DISPERSION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS T2DM
Abdulaziz Jomaa Almohammad Alissa*, Houssam Balleh and Rouba Salman
Background: Individuals with type 2 Diabetes Mellitus(T2DM) are at high risk for development of cardiovascular complications. Treatment with empagliflozin may affect on impaired heart rate variability and impaired ventricular repolarization heterogeneity which associated with the risk of sudden cardiac death(SCD). Objective: the present study aims to assess the effects of empagliflozin on QT dispersion(QTd) and HR variability (HRV) in patients with T2DM. Materials and Methods This is prospective study conducted in the department of cardiology in Tishreen University Hospital-Lattakia -Syria from September 2019 to September 2020. Patients with T2DM who aged 42 to 80 with indication for treatment with empagliflozin were enrolled in the study. QT dispersion, HR variability were reordered before starting empagliflozin and the end of follow up. Results: A total of 40 patients were included, Median age was 52.5 years, 22 (55%) were male, hypertension was detected in 28(70%) of the patients. Empagliflozin reduced glycemia (186.10±54.9 vs125.72±33.3. p:0.0001), systolic blood pressure SBP(132.3±12.7vs 124.9±9.8, p:0.001),QTd (62.22±21.4 vs52.15±22.6, p:0.003), and increased SDNN(89.15±22.2 vs96.40±21.2,p:0.03) in the study participants. Spearman's correlation analysis revealed positive correlation between changes in SBP and QTd(Spearman's =0.6, P=0.0001) and negative correlation with SDNN(Spearman's =-0.3, P=0.02). Reduction in glycemia was correlated with increased in QTd(Spearman's = -0.2, P=0.07) and decreased in SDNN(Spearman's = 0.1, P=0.3). Conclusion: Empagliflozin alters ventricular repolarization indices and impaired HRV, and this could be the mechanism by which empagliflozin reduced cardiovascular events.[Full Text Article]