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Beneficial Effect of Sodium-Glucose Co-transporter 2 Inhibitors on Left Ventricular Function

Fang-Hong Shi1, Hao Li2,3, Long Shen4

  • 1Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

The Journal of Clinical Endocrinology and Metabolism
|November 18, 2021
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve left ventricular (LV) function in patients with heart failure (HF) or diabetes. This meta-analysis confirms SGLT2 inhibitors enhance cardiac function, particularly in HF patients receiving empagliflozin.

Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are known to reduce cardiovascular events in patients with diabetes or heart failure (HF) with reduced ejection fraction.
  • The direct impact of SGLT2 inhibitors on cardiac function, specifically left ventricular (LV) function, remains an area of active investigation.

Purpose of the Study:

  • To determine if SGLT2 inhibitors can improve left ventricular (LV) function in patients with diabetes or heart failure (HF) with reduced ejection fraction.
  • To synthesize evidence from existing studies to provide a comprehensive understanding of SGLT2 inhibitor effects on cardiac parameters.

Main Methods:

  • A systematic literature search was performed across major databases (MEDLINE, EMBASE, Cochrane Library) up to July 2021.
  • Included studies comprised randomized clinical trials and cohort studies reporting LV function variables.
  • A meta-analysis was conducted on data from 13 studies involving 1437 patients.

Main Results:

  • SGLT2 inhibitor treatment significantly improved LV mass (LVM), LV ejection fraction (LVEF), LV volumes (LVEDV, LVESV), and LV diastolic function (E/e', LAVI).
  • Improvements in LV function were particularly noted in patients with HF or those treated with empagliflozin.
  • The meta-analysis included 7 RCTs (640 patients) and 6 cohort studies (797 patients).

Conclusions:

  • SGLT2 inhibitors demonstrably improve left ventricular (LV) function in patients with or without diabetes.
  • The beneficial effects on cardiac function are pronounced in patients with heart failure (HF) and those receiving empagliflozin.
  • These findings support the role of SGLT2 inhibitors in managing cardiac health beyond glycemic control.
Keywords:
cardiovascular diseaseheart failureleft ventricular functionmeta-analysissodium-glucose co-transporter 2 inhibitors

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