Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis
Context: We examined if empagliflozin was associated with modulation of cardiac autonomic tone among subjects with type 2 diabetes and stable coronary artery disease (CAD) relative to placebo. Methods: Using ambulatory 24-h Holter electrocardiographic data prospectively collected from a randomized t...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Metabolism Open |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589936820300190 |
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doaj-7c39f0e119c14f0ca4ec5c95629b9f4b |
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Article |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Vinay Garg Subodh Verma Kim A. Connelly Andrew T. Yan Aditya Sikand Ankit Garg Paul Dorian Fei Zuo Lawrence A. Leiter Bernard Zinman Peter Jüni Atul Verma Hwee Teoh Adrian Quan C. David Mazer Andrew C.T. Ha |
| spellingShingle |
Vinay Garg Subodh Verma Kim A. Connelly Andrew T. Yan Aditya Sikand Ankit Garg Paul Dorian Fei Zuo Lawrence A. Leiter Bernard Zinman Peter Jüni Atul Verma Hwee Teoh Adrian Quan C. David Mazer Andrew C.T. Ha Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis Metabolism Open |
| author_facet |
Vinay Garg Subodh Verma Kim A. Connelly Andrew T. Yan Aditya Sikand Ankit Garg Paul Dorian Fei Zuo Lawrence A. Leiter Bernard Zinman Peter Jüni Atul Verma Hwee Teoh Adrian Quan C. David Mazer Andrew C.T. Ha |
| author_sort |
Vinay Garg |
| title |
Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis |
| title_short |
Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis |
| title_full |
Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis |
| title_fullStr |
Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis |
| title_full_unstemmed |
Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysis |
| title_sort |
does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? the empa-heart cardiolink-6 holter analysis |
| publisher |
Elsevier |
| series |
Metabolism Open |
| issn |
2589-9368 |
| publishDate |
2020-09-01 |
| description |
Context: We examined if empagliflozin was associated with modulation of cardiac autonomic tone among subjects with type 2 diabetes and stable coronary artery disease (CAD) relative to placebo. Methods: Using ambulatory 24-h Holter electrocardiographic data prospectively collected from a randomized trial, we compared changes in heart rate variability (HRV) parameters between empagliflozin- and placebo-assigned subjects over a follow-up period of 6 months. Measured HRV domains included: standard deviation (SD) of NN intervals (SDNN), SD of average NN intervals per 5-min (SDANN), root mean square of successive RR interval differences (RMSSD), % successive NN intervals differing >50 ms (ms) (pNN50), low frequency (LF), high frequency (HF) and the LF/HF ratio (LF:HF). Differences in HRV parameters between the 2 groups were compared with analysis of covariance (ANCOVA). Statistical measures of significance were reported as adjusted differences between the 2 groups and their corresponding 95% confidence intervals. Results: Sixty-six subjects completed 24-h Holter monitoring at baseline and 6-months. Over 6 months, the change in HRV was similar between subjects treated with empagliflozin vs. placebo for the following parameters: RMSSD -1.2 ms (-6.0 to 3.6 ms); pNN50 0.5% (-2.6 to 3.6%); VLF -907.8 ms2 (-2388.8 to 573.1 ms2); LF -341 ms2 (-878.7 to 196.7 ms2); HF -33.8 ms2 (-111.1 to 43.5 ms2); LF:HF -0.1 (-0.4 to 0.2). Subjects who received placebo experienced an increase in SDNN 18.6 ms (2.8–34.3 ms) and SDANN 20.2 ms (3.2–37.3 ms) relative to those treated with empagliflozin. Conclusion: Compared to placebo, empagliflozin did not result in changes in autonomic tone among individuals with type 2 diabetes and stable coronary artery disease. |
| url |
http://www.sciencedirect.com/science/article/pii/S2589936820300190 |
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doaj-7c39f0e119c14f0ca4ec5c95629b9f4b2020-11-25T02:48:39ZengElsevierMetabolism Open2589-93682020-09-017100039Does empagliflozin modulate the autonomic nervous system among individuals with type 2 diabetes and coronary artery disease? The EMPA-HEART CardioLink-6 Holter analysisVinay Garg0Subodh Verma1Kim A. Connelly2Andrew T. Yan3Aditya Sikand4Ankit Garg5Paul Dorian6Fei Zuo7Lawrence A. Leiter8Bernard Zinman9Peter Jüni10Atul Verma11Hwee Teoh12Adrian Quan13C. David Mazer14Andrew C.T. Ha15Division of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, CanadaDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada; Corresponding author. at: Division of Cardiac Surgery, St. Michael’s Hospital, 30 Bond Street, Toronto, ON, Canada, M5B 1W8Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Cardiology, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Division of Cardiology, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, CanadaDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Division of Cardiology, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, CanadaApplied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology and Metabolism, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaDepartment of Cardiology, Southlake Regional Health Centre, University of Toronto, Newmarket, ON, CanadaDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Division of Endocrinology and Metabolism, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, CanadaDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, CanadaDepartment of Physiology, University of Toronto, Toronto, ON, Canada; Department of Anesthesia, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, Toronto, ON, CanadaContext: We examined if empagliflozin was associated with modulation of cardiac autonomic tone among subjects with type 2 diabetes and stable coronary artery disease (CAD) relative to placebo. Methods: Using ambulatory 24-h Holter electrocardiographic data prospectively collected from a randomized trial, we compared changes in heart rate variability (HRV) parameters between empagliflozin- and placebo-assigned subjects over a follow-up period of 6 months. Measured HRV domains included: standard deviation (SD) of NN intervals (SDNN), SD of average NN intervals per 5-min (SDANN), root mean square of successive RR interval differences (RMSSD), % successive NN intervals differing >50 ms (ms) (pNN50), low frequency (LF), high frequency (HF) and the LF/HF ratio (LF:HF). Differences in HRV parameters between the 2 groups were compared with analysis of covariance (ANCOVA). Statistical measures of significance were reported as adjusted differences between the 2 groups and their corresponding 95% confidence intervals. Results: Sixty-six subjects completed 24-h Holter monitoring at baseline and 6-months. Over 6 months, the change in HRV was similar between subjects treated with empagliflozin vs. placebo for the following parameters: RMSSD -1.2 ms (-6.0 to 3.6 ms); pNN50 0.5% (-2.6 to 3.6%); VLF -907.8 ms2 (-2388.8 to 573.1 ms2); LF -341 ms2 (-878.7 to 196.7 ms2); HF -33.8 ms2 (-111.1 to 43.5 ms2); LF:HF -0.1 (-0.4 to 0.2). Subjects who received placebo experienced an increase in SDNN 18.6 ms (2.8–34.3 ms) and SDANN 20.2 ms (3.2–37.3 ms) relative to those treated with empagliflozin. Conclusion: Compared to placebo, empagliflozin did not result in changes in autonomic tone among individuals with type 2 diabetes and stable coronary artery disease.http://www.sciencedirect.com/science/article/pii/S2589936820300190 |