#1

Are there good ways? It’s one endpoint of rapa…

I once got one long ago but I don’t have results anymore…

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#2

Do you mean other than Echocardiography (cardiac ultrasound)?

#3

I was interested in doing this at one point. I searched on Clinicaltrials.gov to find a clinical trial that included an echocardiogram to measure ejection fraction, and where I met the criteria for the study and applied for the control group. I was accepted, but then the study got cancelled during covid. I recommend you try the same thing and look in regions where you live or travel to on occasion.

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#4

I had both an echocardiogram and a cardiac MRI (more accurate in estimating the ejection fraction), but I have to admit that I don’t recall my EF because I was much more interested in what I could do on the treadmill with a Bruce protocol taken to my HR max. If my cardiologist told me it was 55 or70%, I’m not sure it would have much impact on me as long as I scored well on the treadmill.

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#5

I had one done before and after being on Rapa for about a year or so - showed no improvement

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#6

I wouldn’t think it would show improvement unless you had a below normal EF prior to starting Rapa. Even then the abnormal EF would have to be due to something like a cardiomyopathy as opposed to scarring from an MI for Rapa to be effective.

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#7

Why would rapa not be effective post MI?

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#8

I guess you might imagine a scenario where it could help but but generally after an MI the muscle is replaced with scar tissue in the area of infarction leading to conduction and contraction defects that alter the efficiency of ejection. I’m having trouble picturing how rapa might coordinate the replacement of scar with healthy muscle.

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#9

OK, thanks. (I know nothing about the topic.) By the way, I read that “Although the effects of SGLT2 inhibition on cardiac remodeling have only been evaluated in small clinical trials, data suggest it has the potential to reverse cardiac remodeling.” (The influence of dapagliflozin on cardiac remodeling, myocardial function and metabolomics in type 1 diabetes mellitus rats 2023). Do you have any knowledge of this by any chance?

#10

Not my area of expertise either other than what I learned in med school. The paper doesn’t address myocardial infarction, just myocardial function in the setting of DM and remodeling (I assume removal of fat infiltration) in the setting of DM. This would make more sense as “remodeling” is a reversible process where replacement of heart tissue with scar is generally thought of as irreversible.

That’s not to say that remodeling of heart tissue surrounding an infarcted area wouldn’t be beneficial and improve EF modestly in the setting of MI though, I just don’t see it reversing the injury. Some nuance here for sure.

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#11

Does Empagliflozin do the same as Dapa for cardiac remodeling?

#12

I don’t know. My guess is that they’re very similar. I just remember that in the trial for myocardial infarction dapagliflozin did a bit better than empagliflozin.

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#13

@adssx you mean “trial for myocardial function in the setting of DM” correct? Or is there another paper that showed benefit in the setting of myocardial infarction?

#14

Check EMPACT-MI and DAPA-MI on this forum. I don’t think they were on people with T2D specifically (although many participants probably had T2D).

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#15

Recent paper on this: Canagliflozin - Another Top Anti-aging Drug - #938 by adssx

#16

https://x.com/David_Ouyang/status/1906220932622151831?s=19

#17

Getting echo and an EF% is like a 5-10 minute job for any cardiologist. If you can self-pay, I would assume that any private healthcare system would be able to do it for you.

Even aside from Rapa and EF%, it’s worth doing because echo can give you a ton of other information - any structural abnormalities, valve problems, any sort of wall thickening etc.

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