SGLT2 inhibitor therapy significantly improved ventricular-arterial coupling in HFrEF patients (VAC from 2.35±0.87 to 1.82±1.29, p<0.001), reducing adverse events.
Does SGLT2 inhibitor therapy improve ventricular-arterial coupling in patients with HFrEF?
SGLT2 inhibitors significantly improve ventricular-arterial coupling in HFrEF patients, which correlates with reduced NT-proBNP, improved LVEF, and a lower rate of adverse clinical events.
Absolute Event Rate: 0% vs 0%
Abstract Background Several studies have demonstrated the cardioprotective effects of Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) in patients with heart failure (HF), irrespective of the presence of diabetes.Impact on ventricular-arterial coupling (VAC) havent’t been investigated to far. Purpose The purpose of this study was to analyze the effect of SGLT2i on VAC measured non invasively, in patients with HFrEF treated with optimized medical therapy according to current guidelines. Methods We enrolled460 symptomatic HF patients (aged66.8±12.8, NYHA ≥ II, LV ejection fraction 40%) into a multicentric prospective observational study; clinical, laboratory and echocardiographic data were collected in an ambulatory setting, at time of enrolment and after 6-12 and 18 months of therapy with SGLT-2i. Each patient underwent a comprehensive echocardiographic examination including evaluation of deformation imaging parameters and particularly GLS (global longitudinal strain) at baseline and during follow up. Left VAC was derived non invasively by the ratio between Ea (= ESP/SV) and Ees (ESV/ESV). Results During follow up we observed a significant improvement on VAC parameters(from 2.35± 0.87 to 1.82±1.29, p0.001).Benefits were already statistically significant after 6 months of SGLT-2i therapy and were independent from CVRF, comorbidities and concomitant medications. VAC improvement correlated with NTproBNP values reduction(r=-0,343; P=0,0002)and LVEF improvement(r=−0.893; p0.001). Moreover, the group of patients who had achieved a 10% reduction in VAC (n=277) in the 6 months of follow-up had a significantly lower number of adverse events( 23.46% vs 41,53%; p= 0.0001) compared to the group of patients with a reduction ofVAC 10% (n=183) Conclusions Our study demonstrated a significant impact of SGLT-2ion VAC parameters and a better prognosis pf patients with VAC improvement. This study represent a further step forward to understand the pathophysiological mechanisms underlying the extraglicemic benefits produced by SGLT2-i therapy on the cardiovascular homeostasis. VAC measurement represents a simple, inexpensive and easily accessible tool for monitoring response to SGLT2i therapy and a new potential therapeutic target.
Novo et al. (Sat,) reported a other. SGLT2 inhibitor therapy significantly improved ventricular-arterial coupling in HFrEF patients (VAC from 2.35±0.87 to 1.82±1.29, p<0.001), reducing adverse events.