Responders to Sodium-Glucose Cotransporter 2 Inhibitors in Improving Left Ventricular Function

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Sodium-glucose cotransporter 2 inhibitors (SGLT2i) show promise in improving cardiac function in heart failure (HF) patients.
• The specific factors influencing these cardiac improvements with SGLT2i therapy are not well understood.
• HF and type 2 diabetes mellitus (T2DM) often coexist, necessitating research into combined treatment effects.

Purpose of the Study:

• To identify factors associated with cardiac function improvement in patients with HF and T2DM treated with SGLT2i.
• To investigate predictors of enhanced systolic and diastolic function post-SGLT2i initiation.

Main Methods:

• Retrospective analysis of 47 patients with HF and T2DM receiving SGLT2i.
• Transthoracic echocardiography performed at baseline and 3-18 months post-treatment.
• Statistical analysis to determine factors associated with changes in left ventricular ejection fraction (LVEF) and E/e' ratio.

Main Results:

• SGLT2i treatment significantly improved LVEF (39.0% to 54.0%) and reduced E/e' ratio (14.0 to 10.4).
• Younger age, higher serum albumin, and lower serum sodium were independently linked to improved systolic function (LVEF increase ≥ 35%).
• Male sex and impaired renal function showed a trend towards association with improved diastolic function (E/e' ratio decrease ≥ 20%).

Conclusions:

• SGLT2i therapy significantly enhances both systolic and diastolic cardiac function in patients with HF and T2DM.
• Patient characteristics such as age, serum albumin, serum sodium, sex, and renal function play a role in predicting the extent of cardiac improvement.
• These findings highlight the importance of individual patient factors in optimizing SGLT2i therapy for cardiovascular benefits.