SGLT2 inhibitors significantly improved left ventricular mass (WMD -6.319 g; 95% CI -10.850 to -1.789) and other LV function parameters in patients with or without diabetes.
Meta-Analysis (n=1,437)
Do SGLT2 inhibitors improve left ventricular function in patients with or without diabetes?
SGLT2 inhibitors significantly improve left ventricular structural and functional parameters, including LV mass, ejection fraction, and diastolic function, particularly in patients with heart failure.
Mean Difference: -6.319 (95% CI -10.85–-1.789)
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors lowered the risk of cardiovascular events in patients with diabetes or heart failure (HF) with reduced ejection fraction, whether they directly promote cardiac function remains unclear. Therefore, we sought to determine whether SGLT2 inhibitors could improve left ventricular (LV) function in these patients. METHODS: A literature search was conducted using MEDLINE, EMBASE, and Cochrane Library databases from their inception to July 9, 2021. Randomized clinical trials and cohort studies that reported LV function-related variables were included. RESULTS: Thirteen studies comprising 1437 patients (830 SGLT2 inhibitor-treated and 607 non-SGLT2 inhibitor-treated patients) and representing 7 randomized controlled trials with 640 individuals and 6 cohort studies with 797 individuals were included in this meta-analysis. LV regression LV mass (LVM), LV ejection fractions (LVEF), LV volumes LV end-diastolic volumes and systolic volumes (LVEDV and LVESV, respectively, and LV diastolic function mitral inflow E velocity to tissue Doppler e' ratio, E/e' and left atrial volume index (LAVI) were all significantly improved in patients treated with SGLT2 inhibitors (weighted mean differences, 95% CI, LVM: -6.319 g, -10.850 to -1.789; LVEF: 2.458%, 0.693 to 4.224; LVEDV: -9.134 mL, -15.808 to -2.460; LVESV: -8.440 mL, -15.093 to -1.787; LAVI: -2.791 mL/m2, -.554 to -1.027; E/e': -1.567, -2.440 to -0.698). Subgroup analysis further confirmed the improvement of LV function mainly in patients with HF or those receiving empagliflozin treatment. CONCLUSIONS: Treatment with SGLT2 inhibitors can significantly improve LV function in patients with or without diabetes (especially those with HF or undergoing empagliflozin treatment).
Shi et al. (Mon,) conducted a meta-analysis in Diabetes or heart failure (n=1,437). Sodium-glucose cotransporter 2 (SGLT2) inhibitors vs. Non-SGLT2 inhibitor was evaluated on Left ventricular mass (LVM) (WMD -6.319 g, 95% CI -10.850 to -1.789). SGLT2 inhibitors significantly improved left ventricular mass (WMD -6.319 g; 95% CI -10.850 to -1.789) and other LV function parameters in patients with or without diabetes.