The effect of sodium–glucose cotransporter 2 inhibitors on left cardiac remodelling in heart failure with reduced ejection fraction: Systematic review and meta-analysis

Muhammad Shariq Usman, James L. Januzzi, Stefan D. Anker, Ali Salman, Puja B. Parikh, Marianna Adamo, Gerasimos Filippatos, Muhammad Shahzeb Khan, Anuradha Lala, Subodh Verma, Marco Metra, Javed Butler

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: The therapeutic mechanism of sodium–glucose cotransporter 2 inhibitors (SGLT2i) on left cardiac remodelling in patients with heart failure with reduced ejection fraction (HFrEF) is not well-established. This study meta-analysed the impact of SGLT2i on left cardiac structure and function in patients with HFrEF. Methods and results: Online databases were queried up to April 2023 for trials reporting indicators of left cardiac structure and function in patients with HFrEF treated with SGLT2i. Data from studies were pooled using a random-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs). Six trials were included (n = 555). Compared with control, SGLT2i significantly improved left ventricular end-diastolic volume (LVEDV; WMD: −17.07 ml [−23.84, −10.31]; p < 0.001), LVEDV index (WMD: −5.62 ml/m2 [−10.28, −0.97]; p = 0.02), left ventricular end-systolic volume (LVESV; WMD: −15.63 ml [−26.15, −5.12]; p = 0.004), LVESV index (WMD: −6.90 ml/m2 [−10.68, −3.11]; p = 0.001), left ventricular ejection fraction (WMD: 2.71% [0.70, 4.72]; p = 0.008), and left atrial volume index (WMD: −2.19 ml/m2 [−4.26, −0.11]; p = 0.04) in patients with HFrEF. SGLT2i use was associated with a non-significant trend towards a reduction in left ventricular mass index (WMD: −6.25 g/m2 [−12.79, 0.28]; p = 0.06). No significant impact on left ventricular global longitudinal strain was noted (WMD: 0.21% [−0.25, 0.67]; p = 0.38). Conclusions: Sodium–glucose cotransporter 2 inhibitors improve cardiac structure and function in patients with HFrEF.

Original languageEnglish
Pages (from-to)373-382
Number of pages10
JournalEuropean Journal of Heart Failure
Volume26
Issue number2
DOIs
StatePublished - Feb 2024
Externally publishedYes

Keywords

  • Heart failure with reduced ejection fraction
  • Left cardiac remodelling
  • Sodium–glucose cotransporter 2 inhibitors

Fingerprint

Dive into the research topics of 'The effect of sodium–glucose cotransporter 2 inhibitors on left cardiac remodelling in heart failure with reduced ejection fraction: Systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this