Evidence mapPaperPMID 40831792Full record

ArticleCase reports in medicine2025

Dynamic Changes in Fourth Heart Sound in Type 2 Diabetes: Insights From Visualized Phonocardiography and SGLT2 Inhibitor Adjustment.

Kunimasa Yagi, Daisuke Chujo, Shimpei Ogawa, Shumpei Saito, Makoto Iwazawa, Taketsugu Tsuchiya, Shuichi Mizuta, Naohito Yamasaki, Takashi Muro

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Article in Case reports in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Kunimasa YagiDepartment of Internal Medicine, Kanazawa Medical University Hospital, Kanazawa, Ishikawa 920-0293, Japan.ORCID https://orcid.org/0000-0002-6805-6428
Daisuke ChujoCenter for Clinical and Translational Research, Toyama University Hospital, Toyama 930-0152, Japan.
Shimpei OgawaAMI Inc., 2-13 302 Higashisengokucho, Kagoshima 892-0842, Japan.
Shumpei SaitoAMI Inc., 2-13 302 Higashisengokucho, Kagoshima 892-0842, Japan.
Makoto IwazawaAMI Inc., 2-13 302 Higashisengokucho, Kagoshima 892-0842, Japan.
Taketsugu TsuchiyaDepartment of Trans-Catheter Cardiovascular Therapeutics, Kanazawa Medical University Hospital, Kanazawa, Ishikawa 920-0293, Japan.ORCID https://orcid.org/0000-0001-8152-7039
Shuichi MizutaDepartment of Internal Medicine, Kanazawa Medical University Hospital, Kanazawa, Ishikawa 920-0293, Japan.
Naohito YamasakiDepartment of Cardiology and Geriatrics, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
Takashi MuroHeart Valve Center, Midori Hospital, 1-16 Sumiyoshi, Nishi-ku, Kobe, Hyogo 651-2133, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The fourth heart sound (S4) is an auscultatory marker of left ventricular diastolic dysfunction (LVDD). Additionally, S4 correlates with atrial function, which is typically impaired in patients with Type 2 diabetes (T2D) but can improve with sodium-glucose co-transporter-2 inhibitor (SGLT2i) therapy. This case report highlights the dynamic changes in S4 associated with modification of SGLT2i therapy. An 83-year-old male with T2D and LVDD, confirmed via echocardiography, was treated with SGLT2i therapy for 4 years for glycemic control. The therapy was discontinued in December 2023 because of increased nocturnal urination. Two months after discontinuation, the patient developed pronounced S4, accompanied by mild chest discomfort and worsening of evening leg edema. Resumption of SGLT2i therapy led to a marked reduction in S4 along with a remarkable improvement in chest discomfort and edema within 1 month. These findings were confirmed by visual phonocardiography. This case underscores the potential utility of dynamic S4 changes as a noninvasive indicator of SGLT2i therapy adjustment. These findings highlight the novel clinical application of S4 monitoring in mitigating heart failure progression in patients with T2D.

Indexed as

cardiac fourth soundsodium–glucose co-transporter-2 inhibitorsType 2 diabetes mellitusvisualized phonocardiography

Identifiers

PMID40831792
PMCPMC12360888

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.