Why the study?
SGLT2 inhibitors lower incident heart failure and hospitalizations, but their mechanistic effects on invasive hemodynamics remain unclear.
Do SGLT2 inhibitors reduce pulmonary capillary wedge pressure and mean pulmonary artery pressure at rest and peak exercise?
Do SGLT2 inhibitors reduce pulmonary capillary wedge pressure and mean pulmonary artery pressure at rest and peak exercise?
SGLT2 inhibitors significantly reduce pulmonary capillary wedge pressure at rest and peak exercise, providing mechanistic insights into their clinical benefits in heart failure.
Reduces filling pressures during rest and exercise; extends outcome trial data with direct invasive mechanistic evidence in HF.
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to lower incident heart failure (HF) and HF hospitalizations, but the mechanisms of benefit in relation to invasive hemodynamics remain unclear. Using PRISMA guidelines, we systematically reviewed multiple online databases for randomized trials evaluating the effect of SGLT2i on invasive hemodynamics. Rest and peak exercise invasive hemodynamics were measured via right heart catheterization pre- and postintervention. Random effects model meta-analysis at a 95% confidence interval was done using RevMan 5.0. A total of 3 studies with a total of 145 patients were included in the meta-analysis. SGLT2i was significantly associated with a reduction in pulmonary capillary wedge pressure at rest and peak exercise. Similarly, SGLT2i reduced mean pulmonary artery pressure at rest and peak exercise, respectively; however, this was not statistically significant. This hypothesis-generating study offers mechanistic insights into the central hemodynamic effects of SGLT2i underpinning the HF benefits of SGLT2i.
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Idowu et al. (2024) studied this question.
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