Introduction
T2D, HF, microvascular dysfunction, CAD, heart failure, type 2 diabetes
CORONARY STENOSIS, ATRIAL FIBRILLATION, HEART FAILURE, TYPE 2 DIABETES, PATHOGENESIS, CAD
Currently, sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are one of the main treatments for reducing high cardiovascular (CV) mortality in patients with type 2 diabetes (T2D) [In a recent study, Mahmoud et al. suggested that epicardial adipose tissue (EAT) has a pivotal role in the pathogenesis of microvascular dysfunction [Indeed, EAT is considered a modifiable CV risk factor involved in the pathogenesis of CAD, atrial fibrillation, heart failure (HF) and has been recently recognized as a source of therapeutic targets and clinical biomarkers [Thus, the aim of this study was to evaluate whether treatment with the SGLT-2i dapagliflozin, compared to placebo, has an impact on adipose tissue in patients with T2D and stable CAD. To achieve this, we measured morphological (adipose tissue thickness) and metabolic (adipose tissue glucose uptake) changes and determined whether the latter were associated with the increase in MFR previously observed after a 4-week treatment with dapagliflozin [We conducted a phase III multidisciplinary clinical study on a well-selected population of T2D patients with stable CAD (coronary stenosis ≥ 30% and < 80%), with or without previous percutaneous coronary intervention (> 6 months) but no HF, using 2-deoxy-2-[18F]fluoro-D-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) to assess adipose tissue morphology and metabolism during a euglycemic hyperinsulinemic clamp.