Ospedali Riuniti University Hospital, Foggia, Italy.
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Cardiovasc Drugs Ther. 2022 Dec;36(6):1157-1164. doi: 10.1007/s10557-021-07254-3. Epub 2021 Sep 14.
The use of sodium-glucose-cotransporter-type-2 inhibitors (SGLT2i) was associated in previous studies with an improved vascular function in non-human experimental models. We therefore sought to evaluate possible changes in endothelial function assessed by flow-mediated dilation (FMD) in patients with chronic heart failure (CHF) and type-2 diabetes mellitus (T2DM), switching from other oral hypoglycemic agents to SGLT2i in an observational study.
Twenty-two consecutive outpatients with CHF and T2DM were enrolled after switching to SGLT2i therapy, and compared with 23 consecutive controls from the same registry comparable for principal clinical characteristics. In all patients, endothelial function was assessed by FMD at baseline and after 3 months of follow-up.
Three months of therapy with SGLT2i were associated with a statistically significant improvement in endothelial function (19.0 ± 5.7% vs 8.5 ± 4.1%, p < 0.0001); baseline levels of FMD were comparable between groups (p n.s.). Therapy with SGLT2i was significantly associated to improved FMD levels even at multivariable stepwise regression analysis (p < 0.001).
Switch to SGLT2i in patients with CHF and T2DM was associated in an observational non-randomized study with an improved endothelial function.
在之前的研究中，钠-葡萄糖共转运蛋白 2 型抑制剂（SGLT2i）的使用与非人类实验模型中血管功能的改善相关。因此，我们试图在一项观察性研究中评估 22 例慢性心力衰竭（CHF）和 2 型糖尿病（T2DM）患者从其他口服降糖药转换为 SGLT2i 治疗后，通过血流介导的扩张（FMD）评估内皮功能的可能变化。
在转换为 SGLT2i 治疗后，连续纳入 22 例连续门诊患者，并与来自同一登记处的 23 例具有主要临床特征可比性的连续对照者进行比较。所有患者在基线和 3 个月随访时均通过 FMD 评估内皮功能。
SGLT2i 治疗 3 个月与内皮功能的统计学显著改善相关（19.0±5.7%比 8.5±4.1%，p<0.0001）；两组间基线 FMD 水平无差异（p n.s.）。即使在多变量逐步回归分析中，SGLT2i 治疗与 FMD 水平的改善也显著相关（p<0.001）。
在 CHF 和 T2DM 患者中，从 SGLT2i 转换治疗与观察性非随机研究中的内皮功能改善相关。
