Subclinical Changes in Type 2 Diabetes Patients with Heart Failure Stage A and B Treated with Oral Semaglutide

<i>Background and Objectives</i>: Heart failure (HF) among patients with type 2 diabetes (T2DM) is linked to significant morbidity and mortality, despite the increased availability of new drug therapy. This study aims to investigate subclinical changes in patients with HF stage A (at risk for HF) and B (Pre-HF) and T2DM treated with oral semaglutide. <i>Materials and Methods</i>: In a prospective, observational, single-center study, 50 T2DM patients were assessed at baseline and one-year follow-up for changes in spectral Doppler, tissue Doppler, and speckle-tracking (2DST) and metabolic parameters. <i>Results</i>: Correlation and regression analyses identified predictors of Δ GLS. In correlation analysis, Δ GLS showed a negative correlation with Δ VAI (rho = -0.3, <i>p</i> = 0.02), Δ LAP (rho = -0.3, <i>p</i> = 0.04), Δ FPG (rho = -0.3, <i>p</i> = 0.009), Δ TG (rho = -0.4, <i>p</i> = 0.004), and Δ TyG (rho = -0.3, <i>p</i> = 0.02). In linear stepwise regression analysis, the most accurate model, with a <i>p</i>-value < 0.001, was M₃, explaining 70% of the variance in Δ GLS (adjusted R² = 0.7); this model included Δ FPG (beta -0.4, <i>p</i> = 0.001), Δ CRR (beta -1.3, <i>p</i> < 0.001), and Δ LDLc (beta 0.6, <i>p</i> = 0.01). <i>Conclusions:</i> These findings show that improved subclinical left ventricular systolic dysfunction is associated with improved glycemic control, visceral adiposity, and reduced insulin resistance, respectively, with improved lipid profiling.