SGLT2 Inhibitors, Functional Capacity, and Quality of Life in Patients With Heart Failure: A Systematic Review and...

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Sodium glucose cotransporter-2 inhibitors (SGLT2is) are established for reducing mortality and hospitalizations in heart failure (HF).
• Evidence regarding their impact on functional capacity and quality of life (QOL) in HF patients is less consistent.
• This study aimed to systematically evaluate the effects of SGLT2is on objective measures of functional capacity and QOL in HF.

Approach:

• A meta-analysis was conducted on randomized, placebo-controlled trials identified through systematic searches of MEDLINE, EMBASE, and Cochrane databases.
• Included trials reported effects of SGLT2is on exercise capacity (peak VO2, 6MWD) and/or QOL using validated questionnaires.
• Data extraction followed PRISMA 2020 guidelines, with meta-analysis using a restricted maximum likelihood random-effects model.

Key Points:

• The meta-analysis included 17 studies with 23,523 HF patients, followed for 12-52 weeks.
• SGLT2i use was associated with significant improvements in peak VO2 (1.61 mL/kg/min) and 6-minute walk distance (13.09 m).
• Patients on SGLT2is also showed significant improvements in Kansas City Cardiomyopathy Questionnaire scores for symptoms, clinical status, and overall QOL.

Conclusions:

• SGLT2 inhibitors enhance functional capacity and QOL in heart failure patients.
• These improvements in exercise capacity and QOL are significant and consistent across subgroups, including those with varying ejection fractions or diabetes.
• Beyond established benefits in mortality and hospitalization, SGLT2is positively impact patients' daily lives and functional status.