心脏磁共振成像评估沙格列汀对心脏结构和功能的影响:基于16例单中心前瞻性研究

  目的  通过心脏磁共振成像（CMR）评估沙格列汀对未存在心力衰竭的2型糖尿病患者心脏结构和功能的影响。  方法  本研究为前瞻性研究，2型糖尿病无心力衰竭患者使用沙格列汀作为常规指南指导治疗的一部分，共纳入16例患者。临床评估、CMR成像和生物标志物以盲法方式进行评估，并在6月的持续治疗后进行比较。分析治疗6月后左室射血分数的变化和左室及右室舒张末期容量、心室质量、左室整体应变和心脏生物标志物（N末端B型利钠肽前蛋白和高敏感性C反应蛋白）的变化。  结果  本研究中患者（n=16）的平均年龄为59.9岁，其中69%为男性。平均糖化血红蛋白为（8.3±0.9）%，平均治疗前左室射血分数为（57.4±3.4）%，6月后无显著变化（0.2%，95%CI:-2.5~2.1，P=0.86）。CMR分析显示，包括左心室/右心室容积、左心室质量和特征跟踪衍生的应变变化无统计学意义（P>0.05）。N末端B型利钠肽前蛋白和高敏感性C反应蛋白水平变化无统计学意义（P>0.20）。  结论  根据CMR和生物标志物的评估，在本次稳定的2型糖尿病非心衰患者中，沙格列汀治疗6月后与不良的心室重构无关。 

A prospective study of the effects of salbutamol on cardiac structure and function by cardiac magnetic resonance imaging

  Objective  To access the effect of salbutamol on cardiac structure and function by cardiac magnetic resonance imaging (CMR) in T2DM patients without heart failure.  Methods  In this prospective study, patients with T2DM without heart failure were treated with salbutamol as part of routine guideline-guided treatment. Clinical evaluation, CMR imaging and biomarkers were evaluated in a blinded manner and compared after 6 months of continuous treatment. The changes of left ventricular ejection fraction, changes of right ventricular end-diastolic volume, ventricular mass, global strain and cardiac biomarkers (NT-proBNP and hsCRP) were analyzed after 6 months of treatment.  Results  The average age of patients (n=16) in this study was 59.9 years old, 69% of whom were male. The average HbA1c was (8.3±0.9)%, and the mean pretreatment score was (57.4±3.4)%, with no significant change after 6 months [0.2%, 95% CI: (-2.5, 2.1), P=0.86]. CMR showed no change including left/right ventricular volumes, left ventricular mass and characteristic track-derived strain (P>0.05). Levels of N-terminal pro-B-type natriuretic peptide and high-sensitivity C-reactive protein did not change significantly (P>0.20).  Conclusion  According to the evaluation of CMR and biomarkers, salbutamol is not associated with adverse ventricular remodeling after 6 months of treatment in this stable type 2 diabetic non-heart failure patient.