Exploring the role of Glucagon-Like Peptide-1 in heart failure with preserved ejection fraction among patients with type 2 Diabetes Mellitus

Background: The prevalence of cardiac dysfunction in people with type 2 diabetes mellitus (DM) is as high as 35 %. Type 2 diabetes is associated with the development of heart failure with preserved ejection fraction (HFpEF) than with heart failure with reduced ejection fraction (HFrEF). A considerable number of studies have pointed to the advantageous effects of Glucagon Like Peptide-1(GLP-1) on cardiovascular function. Methods: This case-control study was conducted on 48 subjects of them 16 subjects were healthy control (Group I) , 16 subjects formed the type 2 DM without HF group (Group II), and 16 subjects formed the type 2 DM with HFpEF group (Group III). All patients underwent trans-thoracic echocardiography, routine laboratory tests and measurement of fasting levels of serum GLP-1 by (ELISA) kits. The study was conducted in Internal Medicine Department in collaboration with Cardiology Department and Clinical pathology Department, Faculty of Medicine, Zagazig University Hospitals Results: GLP-1 (pmol/L) level was lowest among diabetics with HFpEF followed by patients with diabetes without HF and the highest level was among the healthy controls. A statistically significant negative correlation between GLP-1 and H2FPEF score has been detected among population with type 2 DM. In univariable logistic regression model to assess predictors of HFpEF among patients with type 2 DM, GLP-1 was the only predictor for HFpEF among diabetic patients Conclusion: Low levels of GLP-1 carry a potential risk for HFpEF development among patients with type 2 diabetes; this points to the causation relation between GLP-1 decline and HFpEF occurrence.