SGLT2 Inhibitors Are Associated with Left Ventricular Reverse Remodeling in Patients with Non-Compaction...

Area of Science:

• Cardiology
• Pharmacology

Background:

• Sodium glucose co-transporter 2 inhibitors (SGLT2is) are established treatments for heart failure.
• Limited data exist on SGLT2i efficacy in patients with left ventricular non-compaction cardiomyopathy (LVNC).

Purpose of the Study:

• To investigate the clinical effects of dapagliflozin and empagliflozin in patients diagnosed with LVNC.
• To assess changes in cardiac function and reverse remodeling following SGLT2i initiation.

Main Methods:

• Prospective enrollment of 30 consecutive LVNC patients diagnosed via cardiac magnetic resonance (CMR).
• Collection of clinical, biochemical, and echocardiographic data at baseline and 12-month follow-up.
• Definition of treatment response as a ≥5% improvement in left ventricular ejection fraction (LVEF) at 12 months.

Main Results:

• SGLT2i therapy led to significant improvements in LVEF (32.1% to 43.5%), LVOT VTI, E/e', and TAPSE.
• Mean NT-proBNP levels decreased significantly from 2025 to 582 pg/mL.
• Eighteen patients (60%) demonstrated a favorable response, characterized by smaller baseline LV end-diastolic diameter and lower NT-proBNP levels compared to non-responders.

Conclusions:

• SGLT2 inhibitor therapy is linked to significant reverse remodeling and functional enhancement in LVNC patients.
• The therapeutic benefits of SGLT2is may be more pronounced in individuals with less advanced LVNC disease.