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Different effects of SGLT2 inhibitors according to the presence and types of heart failure in type 2 diabetic patients

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Authors
Hwang, In-Chang; Cho, Goo-Yeong; Yoon, Yeonyee E; Park, Jin Joo; Park, Jun-Bean; Lee, Seung-Pyo; Kim, Hyung-Kwan; Kim, Yong-Jin; Sohn, Dae-Won
Issue Date
2020-05-28
Publisher
BMC
Citation
Cardiovascular Diabetology. 2020 May 28;19(1):69
Keywords
Heart failureDiabetesEchocardiographySodium-glucose cotransporter 2 inhibitorSGLT2 inhibitor
Abstract
Background
The effects of sodium-glucose cotransporter 2 inhibitor (SGLT2i) on cardiac function are not fully understood. We investigated the changes in cardiac function in diabetic patients according to the presence and types of heart failure (HF).

Methods
We retrospectively identified 202 diabetic patients who underwent echocardiography before, and 6 to 24 months after the initiation of SGLT2i. After propensity score matching with diabetic patients without SGLT2i, the study population (n = 304) were categorized into group 1 (without HF nor SGLT2i; n = 76), group 2 (without HF and received SGLT2i; n = 78), group 3 (with HF but without SGLT2i; n = 76), and group 4 (with HF and received SGLT2i; n = 74). Changes in echocardiographic parameters were compared between these 4 groups, and between HF patients with reduced versus preserved ejection fraction (EF).

Results
After a median 13 months of follow-up, HF patients with SGLT2i showed a significant decrease in left ventricular end-diastolic dimension (LV-EDD; from 57.4 mm [50.0–64.9] to 53.0 mm [48.0–60.0]; p < 0.001) and improvement in LV-EF (from 36.1% [25.6–47.5] to 45.0% [34.8–56.3]; p < 0.001). LV mass index and diastolic parameters also showed improvements in HF patients with SGLT2i. The SGLT2i-induced improvements in cardiac function were more prominent in HF patients than those without HF, and in HFrEF patients than HFpEF patients.

Conclusions
Use of SGLT2i improved cardiac function in diabetic patients, regardless of the presence of HF. The improvements were more prominent in HF patients, especially in those with HFrEF. These improvements in cardiac function would contribute to the clinical benefit of SGLT2i.
ISSN
1475-2840
Language
English
URI
http://hdl.handle.net/10371/168590
DOI
https://doi.org/10.1186/s12933-020-01042-3
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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