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We would like to thank Dr. Nishikawa, Dr. Higaki, and Dr. Yamaguchi for their interest in our recent analysis of the effects of imeglimin on endothelial function [1]. We agree that in patients with diabetes, heart failure with preserved ejection fraction (HFpEF) is an important problem that directly affects life expectancy and quality of life. In terms of cardiac indices of atherosclerosis, Nishikawa and colleagues suggested that we not only focus on the cardio–ankle vascular index (CAVI) and the ankle–brachial index (ABI), but also on the systolic time interval (STI). Therefore, we used the CAVI and ABI data to perform an additional analysis of the STI, calculated as the ratio of the pre-ejection period to the left ventricular ejection time. The results of that analysis showed that the STI did not differ significantly before and 3 months after imeglimin administration (median 0.30, interquartile range [IQR] 0.27–0.35 and median 0.33, IQR 0.31–0.36, respectively; p = 0.266); however, our patient population was small and there may have been too few participants to enable an adequate evaluation of the STI. Nishikawa and colleagues also asked whether the study population included patients with heart failure. We can report that the study included one patient with chronic heart failure who had a history of cardiovascular disease; otherwise, none of the patients had heart failure that was symptomatic or that required medication. Unfortunately, not all patients underwent blood tests to assess cardiac function (e.g., brain natriuretic peptide) or echocardiographic evaluation; thus, the potential incidence of HFpEF in this study population was unknown. We hope that the efficacy of imeglimin in HFpEF will be elucidated in the future.
Reference
Uchida T, Ueno H, Konagata A, et al. Improving the effects of imeglimin on endothelial function: a prospective, single-center, observational study. Diabetes Ther. 2023;14(3):569–79. https://doi.org/10.1007/s13300-023-01370-z.
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Funding
No funding or sponsorship was received for this study or publication of this article.
Author Contributions
Taisuke Uchida: data acquisition, study conceptualization, data curation, formal analysis, investigation, methodology, and writing—original draft. Hiroaki Ueno: supervision, validation, and writing—review and editing. Norifumi Taniguchi: data acquisition and writing—review and editing. Fumiko Kogo: data acquisition and writing—review and editing. Yuma Nagatomo: data acquisition and writing—review and editing. Koichiro Shimizu: data acquisition and writing—review and editing. Hideki Yamaguchi: supervision and writing—review and editing. Kazuya Shimoda: project administration, supervision, validation, and writing—review and editing. All authors have approved the submitted version of the manuscript and have agreed to be accountable for all parts of the work.
Disclosures
Taisuke Uchida, Hiroaki Ueno, Norifumi Taniguchi, Fumiko Kogo, Yuma Nagatomo, Koichiro Shimizu, Hideki Yamaguchi and Kazuya Shimoda declare that they have no competing interests in connection with the submitted material.
Compliance with Ethics Guidelines
The protocol for the research project was approved by the ethics board of the University of Miyazaki (Approval no. O-1074), and it conforms to the provisions of the Declaration of Helsinki of 1964 and its later amendments. The research was registered in the University Hospital Medical Information Network (UMIN: UMIN000046311), and informed consent was obtained from all subjects. This letter is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.
Data Availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Uchida, T., Ueno, H., Konagata, A. et al. A Response to Letter to the Editor: Can Imeglimin Improve the Systolic Time Intervals in Diabetes Mellitus?. Diabetes Ther 14, 1075–1076 (2023). https://doi.org/10.1007/s13300-023-01409-1
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DOI: https://doi.org/10.1007/s13300-023-01409-1