The effect of Treatment with SGLT2 Inhibitor on Right Ventricular Function in Heart Failure and Low Ejection Fraction patients

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i), are now revolutionary therapy in heart failure with reduced ejection fraction patients (HFrEF) This study aimed to evaluate the effect of treatment with sglt2 inhibitor on right ventricular function in heart failure and low ejection fraction patients who underwent optimal medical therapy (OMT). Methods: This prospective single center (Benha University Hospital) study included 100 patients diagnosed with HFrEF according to the ESC guidelines. Patients were selected and divided into two equal groups: The OMT + SGLT2 inhibitor group: 50 patients received the SGLT2 inhibitor in addition to background OMT for 3 months’ time. The OMT control group: 50 patients received background OMT without the addition of SGLT2i. All studied cases were subjected to the following: Detailed history taking, full clinical examination, and Routine laboratory investigations. Results: Patients with HFrEF who were randomized to OMT+SGLT2 experienced a significant improvement in all RV functional echocardiographic parameters from baseline to 3 months follow up, as reflected in the mean absolute changes as follows: TAPSE (2.2 mm, p < 0.001), FAC (12%, p < 0.001), TR V max (-1.1m/s, p < 0.001), PASP (-23mmHg, p < 0.001), RV FWS (7.5%, p < 0.001). In multivariate regression, OMT + SGLT2 was associated with 0.375 increase in TAPSE, 10.923 increase in FAC, 1.052 decrease in TR V max, and 21.839 decrease in PASP compared to OMT alone. Conclusion: We can safely conclude that SGLT2 inhibitors significantly improve the right ventricular function in patients with heart failure and reduced ejection fraction who receive OMT.