The effect of glucagon‐like peptide‐1 receptor agonists on cardiac function and structure in patients with or without type 2 diabetes mellitus: An updated systematic review and meta‐analysis

Abstract

AbstractAimsTo conduct an updated systematic review and meta‐analysis to evaluate the efficacy of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) with regard to cardiac function and structure in people with or without type 2 diabetes mellitus (T2DM).Materials and MethodsWe conducted a systematic search using the PubMed, Embase and ClinicalTrials.gov online databases. The primary outcome of interest was changes in mitral inflow E‐velocity to tissue Doppler e' velocity (E/e') ratio. Secondary outcomes included other indicators of cardiac reverse remodelling and functional capacity comprising changes in left ventricular mass (LVM), left ventricular global longitudinal strain, left ventricular end‐diastolic volume, left ventricular end‐systolic volume, left ventricular ejection fraction (LVEF), early to atrial mitral inflow velocity ratio, left atrial volume (LAV), N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels and 6‐min walk test (6MWT) results.ResultsA total of 15 trials involving 898 patients were included in this analysis. GLP‐1RAs significantly improved E/e' ratio (mean difference [MD] = −0.73; 95% confidence interval [CI] −1.34, −0.13), LVM (MD = −3.86 g; 95% CI −7.60, −0.12), LAV (MD = −8.20 mL; 95% CI −12.37, −4.04), NT‐proBNP level (standardized MD = −0.27; 95% CI −0.47, −0.06), and 6MWT result (MD = +22.31 m; 95% CI 1.64, 42.99). However, GLP‐1RAs had no effect on LVEF (MD = +0.31%; 95% CI −1.02, 1.64).ConclusionsIn this systematic review and meta‐analysis, GLP‐1RAs were found to have a positive impact on left ventricle diastolic function, hypertrophy, and exercise capacity, but had no effect on systolic function.