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.

AIMS: To 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 METHODS: We 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. RESULTS: A 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). CONCLUSIONS: In 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.

Changes in the Expression of MIF and Other Key Enzymes of Energy Metabolism in the Myocardia of Broiler Chickens with Ascites Syndrome.

Ascites syndrome (AS) is a metabolic disease observed mainly in fast-growing broilers. The heart is one of the most important target organs of the disease. The goal of this study was to evaluate the metabolic function of the right ventricles in clinical ascitic broilers. HE staining was performed to observe histopathological changes in the right ventricle of the heart, while Western blotting was used to detect the protein expression levels of macrophage migration inhibitory factor (MIF) and phosphorylated AMP-activated protein kinase (p-AMPK), as well as other key enzymes of energy metabolic pathways (i.e., glycolytic pathway: HK2, PFK1, PFK2, and PKM2; the tricarboxylic acid cycle (TCA cycle) pathway: OGDH, IDH2, and CS; and the fatty acid oxidation pathway: CPT-1A and ACC) in myocardial tissue. The histopathological examination of the myocardia of ascitic broilers revealed disoriented myocardial cells in the myofibril structure and a large number of blood cells deposited in the intermyofibrillar vessels, suggesting right heart failure in ascitic broilers. The Western blotting analysis demonstrated significantly increased levels of MIF and p-AMPK in the myocardia of ascitic broilers compared to those of the control group (p < 0.05). Additionally, the protein expression of key enzymes was dramatically increased in the glycolytic and fatty acid oxidation pathways, while the protein expression of key enzymes in the TCA cycle pathway was decreased in the ascitic broiler group. These findings suggest enhanced glycolysis and fatty acid oxidation metabolism, and a diminished TCA cycle, in the myocardia of broiler chickens with ascites syndrome.