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Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
06:29

Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring

Published on: May 2, 2025

Real-world experience with sodium-glucose cotransporter 2 inhibitors in adults with Fontan circulatory failure

Ralph M L Neijenhuis1,2,3, Ari M Cedars4, Ali Zaidi5

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.

Frontiers in Cardiovascular Medicine
|May 25, 2026
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) show promise for treating Fontan circulatory failure (FCF). This study found SGLT2i safe and effective, reducing NT-proBNP levels in FCF patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Fontan physiology predisposes patients to Fontan circulatory failure (FCF).
  • Current pharmacological treatments for FCF lack evidence-based options.
  • This study investigates sodium-glucose cotransporter 2 inhibitors (SGLT2i) for FCF management.

Purpose of the Study:

  • To evaluate the safety and efficacy of SGLT2i in adult patients with FCF.
  • To compare treatment responses in patients with reduced (FCFrEF) versus preserved (FCFpEF) ventricular function.

Main Methods:

  • A real-world, multicenter study utilizing the ACHIEVE-SGLT2i registry (NCT06932081).
  • Collected data on side effects, treatment discontinuation, and clinical outcomes.
  • Analyzed longitudinal changes in biomarkers and clinical parameters pre- and post-SGLT2i initiation using linear mixed models.

Main Results:

  • Thirty-three adult FCF patients (51.5% female, 33.3% FCFrEF, 66.7% FCFpEF) were included.
  • SGLT2i were generally safe, with 15.2% reporting side effects and 9.1% discontinuing treatment.
  • NT-proBNP levels significantly decreased by 26.5% (p=0.010) in the year after SGLT2i initiation, irrespective of ventricular function.

Conclusions:

  • SGLT2i are safe and well-tolerated in adult FCF patients.
  • SGLT2i treatment is associated with a significant reduction in NT-proBNP.
  • These findings support SGLT2i as a potential therapeutic option for FCF.
Keywords:
FCFSGLT2Iadult congenital heart disease (ACHD)heart failuresingle ventricleuniventricular

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