Long-Acting GLP-1 Receptor Agonist Exenatide Influence on the Autonomic Cardiac Sympatho-Vagal Balance
Open accessAbstract
Long-acting glucagon-like peptide 1 receptor agonists are increasingly used to treat type 2 diabetes. An increase of heart rate (HR) has been observed with their use. To elucidate the role of the cardiac sympatho-vagal balance as a possible mediator of the reported increase in HR, we performed power spectral analysis of HR variability (HRV) in patients receiving exenatide extended-release (ER). Twenty-eight ambulatory patients with type 2 diabetes underwent evaluation at initiation of exenatide-ER and thereafter at 3 and at 6 months. To obtain spectral analyses of HRV, a computerized acquisition of 10 minutes of RR electrocardiogram intervals (mean values of ~700 RR intervals) were recorded both in lying and in standing positions. All patients showed a substantial increase of HR both in lying and in standing positions. Systolic blood pressure, body weight, and glycated hemoglobin A1c significantly decreased both at 3 and 6 months compared with basal levels. The low-frequency/high-frequency ratio varied from 3.05 ± 0.4 to 1.64 ± 0.2 (P < 0.001) after 3 months and to 1.57 ± 0.3 (P < 0.001) after 6 months in a lying position and from 4.56 ± 0.8 to 2.24 ± 0.3 (P < 0.001) after 3 months and to 2.38 ± 0.4 (P < 0.001) after 6 months in a standing position compared with basal values, respectively. HR variations, induced by exenatide-ER treatment, do not appear to be related to sympathetic autonomic tone. Of note, we observed a relative increase of vagal influence on the heart.
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Discrepant findings are available for activation of the cardiac sympathetic nervous system.
“Similarly, discrepant findings are available for activation of the (cardiac) sympathetic nervous system”
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- Authors
- Cacciatori, V., Zoppini, G., Bellavere, F., Rigolon, R., Thomaseth, K., Pichiri, I., Trombetta, M., Dauriz, M., De Santi, F., Targher, G., Santi, L., & Bonora, E.
- Affiliations
- University of Verona (IT)
- National Research Council (IT)
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
- Corresponding author
- Zoppini, Giacomo
- ORCID
- Venue
- Journal of the Endocrine Society
- Publisher
- The Endocrine Society
- Published
- 2017-11-06
- Volume
- 2
- Issue
- 1
- Pages
- 53-62
- ISSN
- 2472-1972 (ISSN-L)
- PMC
- PMC5779107
- OpenAlex
- W2767216468
- Cited by
- 18
- References
- 41
- Citations by year
- 2026: 4 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 2 · 2019: 4
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of the Endocrine Society (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- exenatide extended-release, GLP-1 receptor agonists, type 2 diabetes, heart rate variability, sympathovagal balance, vagal tone, sympathetic tone, LF/HF ratio, autonomic nervous system, heart rate increase, blood pressure
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