SGLT2 inhibitors significantly improved cardiac remodeling in heart failure patients, including a reduction in left ventricular end-diastolic volume (MD -8.41 mL; 95% CI -13.07 to -3.75; P=0.004).
Meta-Analysis (n=1,181)
Do sodium-glucose co-transporter 2 inhibitors improve cardiac remodeling parameters in patients with heart failure?
SGLT2 inhibitors significantly improve cardiac remodeling parameters, including increasing LVEF and reducing ventricular volumes, in patients with heart failure.
Mean Difference: -8.41 (95% CI -13.07–-3.75)
p-value: p=0.004
Abstract Background: Several studies have demonstrated the safety and efficacy of sodium–glucose co-transporter 2 inhibitors (SGLT2i), but there is little evidence on how these drugs improve cardiac remodeling parameters in patients with heart failure (HF). We performed a meta-analysis of RCTs to evaluate the effect of SGLT2i on cardiac remodeling in patients with HF. The study protocol was registered in June 2025 (PROSPERO: CRD420251055562). Methods: The Medline, Scopus, and Cochrane Central databases were searched for RCTs that compared SGLT2i with placebo in patients ≥18 years of age with a diagnosis of HF. Eleven outcomes were analyzed, including left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVES), left ventricular mass (LVM), left ventricular ejection fraction (LVEF), left atrial volume indexed (LAVi), left ventricular global longitudinal Strain, stroke volume, and E/e’. Statistical analyses were performed using R version 4.3.2. Results: We included 13 RCTs with 1181 patients, 592 of whom received SGLT2i as the intervention. LVEDV (MD: −8.41 mL; 95% CI: −13.07 to − 3.75, P = 0.004), LVES (MD: −8.11 mL; 95% CI: −13.95 to −2.28, P = 0,006), left ventricular end-systolic volume indexed (LVESVi) (MD: −3.71 mL/m 2 , 95% CI: −6.84 to − 0.58, P = 0.02), LVM (MD: −7.65 g; 95% CI: −13.79 to −1.51, P = 0.01), and LAVi (MD: −2.04 ml/m 2 ; 95% CI: −3.21 to − 0.86, P = 0.0007) were significantly lower in patients treated with SGLT2i compared to placebo. In addition, this treatment led to a significant increase in LVEF (MD: +2.59%, 95% CI: 1.76 to 3.43, P < 0.00001) compared to placebo. Conclusion: Our results suggest that in patients with HF, SGLT2i have a positive influence on cardiac remodeling since they lead to a significant decrease in LVEDV, LVES, LVESVi, LVM, left ventricular mass indexed, and LAVi compared to placebo and a significant increase in EF.
Giannino et al. (Wed,) conducted a meta-analysis in Heart failure (n=1,181). Sodium–glucose co-transporter 2 inhibitors (SGLT2i) vs. Placebo was evaluated on Left ventricular end-diastolic volume (LVEDV) (MD -8.41, 95% CI -13.07 to -3.75, p=0.004). SGLT2 inhibitors significantly improved cardiac remodeling in heart failure patients, including a reduction in left ventricular end-diastolic volume (MD -8.41 mL; 95% CI -13.07 to -3.75; P=0.004).