Systemic HypertensionSystemic HypertensionСистемные гипертензии2075-082X2542-2189Intermedservice Ltd9650410.26442/2075082X.2021.4.201305Case ReportКлинический случайResearch ArticlePossibilities of a new glucagon-like peptide-1 receptor agonist Semaglutide in improving left ventricular diastolic function in a patient with arterial hypertension and type 2 diabetes mellituВозможности нового представителя агониста рецепторов глюкагоноподобного пептида-1 семаглутида в улучшении диастолической функции левого желудочка у пациентки с артериальной гипертонией и сахарным диабетом 2-го типаAzimovaMakka R.АзимоваМакка Ризвановна
Russian Federation

cardiologist, Graduate Student, Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

врач-кардиолог, аспирант отд. гипертонии Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

azimovamak@gmail.comhttps://orcid.org/0000-0001-7895-9068ZhernakovaJulia V.ЖернаковаЮлия Валерьевна
Russian Federation

D. Sci. (Med.), Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

д-р мед. наук, ученый секретарь Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

juli001@mail.ruMyasnikov Institute of Clinical Cardiology, National Medical Research Center of CardiologyИнститут клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России151220211841861921601202216012022Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2075-082X/article/view/96504

The emergence of new classes of glucose-lowering drugs that can further reduce cardiovascular risk (CVR) have fundamentally changed the approach to the management of patients with type 2 diabetes mellitus. The most significant changes concerned the strategy of choosing glucose-lowering therapy with a change in priorities from the glycemia level to CVR, which plays a key role in choosing a class of antidiabetic drugs. At the same time, the mechanisms responsible for lowering CVR remain largely unclear. Of undoubted interest is the study of effects of a new glucagon-like peptide-1 receptor agonist, Semaglutide, on the preclinical stage of diastolic dysfunction. The article presents a clinical case of the use of Semaglutide in a patient with arterial hypertension and type 2 diabetes mellitus.

Появление новых классов сахароснижающих препаратов, позволяющих добиться дополнительного снижения сердечно-сосудистого риска (ССР), кардинально изменило подходы к ведению пациентов с сахарным диабетом 2-го типа. Наиболее значимые изменения коснулись стратегии выбора сахароснижающей терапии со сменой приоритетов с уровня гликемии на уровень ССР, которому отдана ведущая роль при выборе класса антидиабетических препаратов. Вместе с тем механизмы, посредством которых снижается ССР, во многом остаются неизученными. Изучение возможностей влияния нового представителя агониста рецепторов глюкагоноподобного пептида-1 семаглутида на доклиническую стадию диастолической дисфункции представляет несомненный интерес. Статья посвящена описанию клинического случая использования семаглутида у пациентки с артериальной гипертонией и сахарным диабетом 2-го типа.

diabetes mellitusantidiabetic drugsSemaglutideсахарный диабетантидиабетические препаратысемаглутидKassebaum NJ, Arora M, Barber RM, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the global burden of Disease Study 2015. Lancet. 2016;388(10053):1603-58. DOI:10.1016/S0140-6736(16)31460-XБойцов С.А., Баланова Ю.А., Шальнова С.А., и др. Артериальная гипертония среди лиц 25–64 лет: распространенность, осведомленность, лечение и контроль. По материалам исследования ЭССЕ. Кардиоваскулярная терапия и профилактика. 2014;13(4):4-14 [Boitsov SA, Balanova IuA, Shal'nova SA, et al. Arterial hypertension among individuals of 25–64 years old: prevalence, awareness, treatment and control. By the data from ECCD. Cardiovascular Therapy and Prevention. 2014;13(4):4-14 (in Russian)]. DOI:10.15829/1728-8800-2014-4-4-14Morris NJ, Wang SL, Stevens LK, et al. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia. 2001;44(Suppl. 2):14-21. DOI:10.1007/pl00002934Rydén L, Grant P, Anker S, et al. Рекомендации по диабету, предиабету и сердечно-сосудистым заболеваниям. EASD/ESC. Российский кардиологический журнал. 2014;3:7-61 [Rydén L, Grant P, Anker S, et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Russian Journal of Cardiology. 2014;3:7-61 (in Russian)]. DOI:10.15829/1560-4071-2014-3-7-61Zabalgoitia M, Ismaeil MF, Anderson L, Maklady FA. Prevalence of diastolic dysfunction in normotensive, asymptomatic patients with well-controlled type 2 diabetes mellitus. Am J Cardiol. 2001;87(3):320-3. DOI:10.1016/s0002-9149(00)01366-7Bouthoorn S, Valstar GB, Gohar A, et al. The prevalence of left ventricular diastolic dysfunction and heart failure with preserved ejection fraction in men and women with type 2 diabetes: a systematic review and meta-analysis. Diab Vasc Dis Res. 2018;15:477-93. DOI:10.1177/1479164118787415Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-200. DOI:10.1093/eurheartj/ehw128Ahrén B, Masmiquel L, Kumar H, et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): A 56-week, double-blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol. 2017;5(5):341-54. DOI:10.1016/S2213-8587(17)30092-XSorli C, Harashima SI, Tsoukas GM, et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): A double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017;5:251-60. DOI:10.1016/S2213-8587(17)30013-XAhmann AJ, Capehorn M, Charpentier G, et al. Efficacy and safety of once-weekly semaglutide versus exenatide ER in subjects with type 2 diabetes (SUSTAIN 3): A 56-week, open-label, randomized clinical trial. Diabetes Care. 2018;41(2):258-66. DOI:10.2337/dc17-0417Rodbard HW, Lingvay I, Reed J, et al. Semaglutide added to basal insulin in type 2 diabetes (SUSTAIN 5): A randomised, controlled trial. J Clin Endocrinol Metab. 2018;103:2291-301. DOI:10.1210/jc.2018-00070Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834-44. DOI:10.1056/NEJMoa1607141Liu JE, Palmieri V, Roman MJ, et al. The impact of diabetes on left ventricular filling pattern in normotensive and hypertensive adults: the Strong Heart Study. J Am Coll Cardiol. 2001;37:1943-49. DOI:10.1016/S0735-1097(01)01230-XYancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62:e147-239. DOI:10.1016/j.jacc.2013.05.019From AM, Scott CG, Chen HH. Changes in diastolic dysfunction in diabetes mellitus over time. Am J Cardiol. 2009;103:1463-6. DOI:10.1016/j.amjcard.2009.01.358Hammer S, Snel M, Lamb HJ, et al. Prolonged caloric restriction in obese patients with type 2 diabetes mellitus decreases myocardial triglyceride content and improves myocardial function. J Am Coll Cardiol. 2008;52(12):1006-12. DOI:10.1016/j.jacc.2008.04.068Çetin M, Kocaman SA, Durakoğlugil ME, et al. Effect of epicardial adipose tissue on diastolic functions and left atrial dimension in untreated hypertensive patients with normal systolic function. J Cardiol. 2013;61(5):359-64. DOI:10.1016/j.jjcc.2012.12.015Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2(10):536-43. DOI:10.1038/ncpcardio0319Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153(6):907-17. DOI:10.1016/j.ahj.2007.03.019Koska J, Sands M, Burciu C, et al. Exenatide protects against glucose- and lipid-induced endothelial dysfunction: evidence for direct vasodilation effect of GLP-1 receptor agonists in humans. Diabetes. 2015;64:2624-35. DOI:10.2337/db14-0976Baggio LL, Yusta B, Mulvihill EE, et al. GLP-1 receptor expression within the human heart. Endocrinology. 2018;159:1570-84. DOI:10.1210/en.2018-00004Gaspari T, Liu H, Welungoda I, et al. A GLP-1 receptor agonist liraglutide inhibits endothelial cell dysfunction and vascular adhesion molecule expression in an ApoE-/- mouse model. Diab Vasc Dis Res. 2011;8(2):117-24. DOI:10.1177/1479164111404257Del Olmo-Garcia MI, Merino-Torres JF. GLP-1 Receptor Agonists and Cardiovascular Disease in Patients with Type 2 Diabetes. J Diabetes Res. 2018;2018:4020492. DOI:10.1155/2018/4020492Lonborg J, Vejlstrup N, Kelbæk H, et al. Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. Eur Heart J. 2012;33(12):1491-9. DOI:10.1093/eurheartj/ehr309Woo JS, Kim W, Ha SJ, et al. Cardioprotective effects of exenatide in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention: results of exenatide myocardial protection in revascularization study. Arterioscler Thromb Vasc Biol. 2013;33(9):2252-60. DOI:10.1161/ATVBAHA.113.301586.Bizino MB, Jazet IM, Westenberg JJM, et al. Effect of liraglutide on cardiac function in patients with type. 2 diabetes mellitus: randomized placebo-controlled trial. Cardiovasc Diabetol. 2019;18:55. DOI:10.1186/s12933-019-0905-2Saponaro F, Sonaglioni A, Rossi A, et al. Improved diastolic function in type. 2 diabetes after a six month liraglutide treatment. Diabetes Res Clin Pract. 2016;118:21-8. DOI:10.1016/j.diabres.2016.04.046Scalzo RL, Moreau KL, Ozemek C, et al. Exenatide improves diastolic function and attenuates arterial stiffness but does not alter exercise capacity in individuals with type. 2 diabetes. J Diabetes Complicat. 2017;31:449-55. DOI:10.1016/j.jdiacomp.2016.10.003