SGLT2 inhibitor therapy in adult Fontan patients significantly increased median maximum oxygen uptake from 20.1 to 24.2 mL/kg/min (p=0.008) over an average of 11 months.
Observational (n=17)
Do SGLT2 inhibitors improve exercise capacity and are they safe in adult patients with Fontan circulation?
SGLT2 inhibitors appear safe and may significantly improve exercise capacity (VO2 max) in adult patients with Fontan circulation.
Absolute Event Rate: 24.2% vs 20.1%
p-value: p=0.008
BACKGROUND: We still know little about the effective pharmacological treatment of heart failure (HF) associated with the Fontan circulation. One of the new options may be sodium glucose cotransporter-2 inhibitors (SGLT2i), which have been proven effective in classic forms of left ventricular HF. OBJECTIVES: To evaluate the effect and safety of SGLT2i inclusion in adults with Fontan circulation. To this end, we conducted observation and complex diagnostics of adult Fontan patients in whom we started treatment with flozins. MATERIAL AND METHODS: The study population consisted of 17 adult Fontan patients with average age 30.5 (9.7) years, 59% in II New York Heart Association (NYHA) class, among whom 53% received dapagliflozin and rest empagliflozin. RESULTS: The average observation time was 11.0 (3.7) months. None of the patients have reported side effects or complications related to treatment. We observed a significant increase (20.1 mL/kg/min vs 24.2 mL/kg/min, p = 0.008) in the median of maximum oxygen uptake (VO2 max) among participants (9) who completed at least 2 reliable cardiopulmonary exercise tests. We did not notice any significant differences in N-terminal prohormone of brain natriuretic peptide concentration (641.35 (923.7) vs 741.47 (1,139.02), p = 0.12) after the inclusion. Interestingly, we observed a significant increase in erythrocytes (+6%, p = 0.003), hemoglobin (+7%, p = 0.03) and hematocrit (+7%, p = 0.02). CONCLUSIONS: To the best of our knowledge, this is the first study to demonstrate that the implementation of SGLT2i may have a positive effect on exercise capacity among adults with Fontan circulation. Our experience confirms the high safety of using these drugs in Fontan adults.
Skorek et al. (Tue,) conducted a observational in Adult patients with Fontan circulation (n=17). Sodium glucose cotransporter-2 inhibitors (dapagliflozin or empagliflozin) vs. Baseline (before treatment) was evaluated on Maximum oxygen uptake (VO2 max) (p=0.008). SGLT2 inhibitor therapy in adult Fontan patients significantly increased median maximum oxygen uptake from 20.1 to 24.2 mL/kg/min (p=0.008) over an average of 11 months.
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