Sodium-glucose cotransporter 2 inhibitors significantly improved left ventricular end-diastolic volume compared with control in patients with HFrEF (WMD -17.07 ml; 95% CI -23.84 to -10.31; p<0.001).
Meta-Analysis (n=555)
Do sodium-glucose cotransporter 2 inhibitors improve left cardiac structure and function in patients with heart failure with reduced ejection fraction?
SGLT2 inhibitors significantly improve echocardiographic parameters of left ventricular reverse remodeling, including LVEDV, LVESV, and LVEF, in patients with HFrEF.
Mean Difference: -17.07 (95% CI -23.84–-10.31)
p-value: p=< 0.001
ABSTRACT Aims The therapeutic mechanism of sodium–glucose cotransporter 2 inhibitors (SGLT2i) on left cardiac remodelling in patients with heart failure with reduced ejection fraction (HFrEF) is not well-established. This study meta-analysed the impact of SGLT2i on left cardiac structure and function in patients with HFrEF. Methods and results Online databases were queried up to April 2023 for trials reporting indicators of left cardiac structure and function in patients with HFrEF treated with SGLT2i. Data from studies were pooled using a random-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs). Six trials were included (n = 555). Compared with control, SGLT2i significantly improved left ventricular end-diastolic volume (LVEDV; WMD: −17.07 ml −23.84, −10.31; p 0.001), LVEDV index (WMD: −5.62 ml/m2 −10.28, −0.97; p = 0.02), left ventricular end-systolic volume (LVESV; WMD: −15.63 ml −26.15, −5.12; p = 0.004), LVESV index (WMD: −6.90 ml/m2 −10.68, −3.11; p = 0.001), left ventricular ejection fraction (WMD: 2.71% 0.70, 4.72; p = 0.008), and left atrial volume index (WMD: −2.19 ml/m2 −4.26, −0.11; p = 0.04) in patients with HFrEF. SGLT2i use was associated with a non-significant trend towards a reduction in left ventricular mass index (WMD: −6.25 g/m2 −12.79, 0.28; p = 0.06). No significant impact on left ventricular global longitudinal strain was noted (WMD: 0.21% −0.25, 0.67; p = 0.38). Conclusions Sodium–glucose cotransporter 2 inhibitors improve cardiac structure and function in patients with HFrEF.
Usman et al. (Thu,) conducted a meta-analysis in Heart failure with reduced ejection fraction (HFrEF) (n=555). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) vs. Control was evaluated on Left ventricular end-diastolic volume (LVEDV) (WMD -17.07 ml, 95% CI -23.84, -10.31, p=< 0.001). Sodium-glucose cotransporter 2 inhibitors significantly improved left ventricular end-diastolic volume compared with control in patients with HFrEF (WMD -17.07 ml; 95% CI -23.84 to -10.31; p<0.001).