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Switch to gliflozins and biventricular function improvement in patients with chronic heart failure and diabetes

Michele Correale1, Pietro Mazzeo2, Martino Fortunato2

  • 1Ospedali Riuniti University Hospital, Foggia, Italy.

Clinical Physiology and Functional Imaging
|October 5, 2023
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly improved heart function in patients with diabetes and chronic heart failure (CHF). This real-world study demonstrates enhanced left and right ventricular function after SGLT2 inhibitor therapy.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are known to reduce hospitalizations in patients with chronic heart failure (CHF).
  • The precise cardioprotective mechanisms of SGLT2 inhibitors, also known as gliflozins, remain incompletely understood.
  • This study aimed to investigate the impact of SGLT2 inhibitors on right and left ventricular function in individuals with diabetes and heart failure.

Purpose of the Study:

  • To evaluate the effects of SGLT2 inhibitors on cardiac function.
  • To assess changes in both left and right ventricular function.
  • To explore these effects in patients with co-existing diabetes and heart failure.

Main Methods:

  • Seventy-eight patients with diabetes and CHF were enrolled.
  • 38 patients initiated SGLT2 inhibitor treatment, while 40 continued their existing antidiabetic therapy.
  • Echocardiography, including conventional, tissue Doppler imaging (TDI), and strain imaging, was performed at baseline and after 3 months.

Main Results:

  • SGLT2 inhibitor therapy led to significant improvements in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and global longitudinal strain (GLS).
  • Right ventricular function also showed significant improvements, indicated by enhanced TAPSE and RV S' values.
  • Pulmonary artery systolic pressure (PAsP) and both mitral and tricuspid regurgitation were reduced, with no significant changes observed in the control group.

Conclusions:

  • SGLT2 inhibitors are associated with improved left and right ventricular function in patients with CHF and diabetes in a real-world setting.
  • These findings suggest potential anti-remodeling effects of gliflozins.
  • Echocardiographic assessment supports the beneficial impact of SGLT2 inhibitors on cardiac structure and function.
Keywords:
PAsPSGLT2 inhibitorsTAPSEdiabetesgliflozinsleft ventricular functionright ventricular function

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