Theofilis Panagiotis, Antonopoulos Alexios S, Katsimichas Themistoklis, Oikonomou Evangelos, Siasos Gerasimos, Aggeli Constantina, Tsioufis Konstantinos, Tousoulis Dimitris
1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.
1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece; 3rd Cardiology Department, "Sotiria" Chest Diseases Hospital, University of Athens Medical School, Athens, Greece.
Pharmacol Res. 2022 Jun;180:106243. doi: 10.1016/j.phrs.2022.106243. Epub 2022 May 4.
The use of sodium-glucose cotransporter-2 inhibitors (SGLT2-Is) has resulted in significant benefits in patients with heart failure irrespective of left ventricular ejection fraction (LVEF) and the presence of diabetes mellitus. The aim of this systematic review and meta-analysis was to assess the impact of SGLT2-Is on cardiac function indices.
We conducted a systematic literature search for studies assessing the changes in LVEF, global longitudinal strain (GLS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular mass index (LVMi), left atrial volume index (LAVi), and E/e' following the initiation of an SGLT2-I.
A total of 32 studies with 2351 patients were included. SGLT2 inhibition resulted in a significant improvement of LVEF [MD 1.97 (95%CI 0.92, 3.02), p < .01, I:84%] in patients with heart failure, an increase in GLS [MD 1.17 (95% CI 0.25, 2.10), p < .01], a decrease in LVESV [MD: -3.60 (95% CI -7.02, -0.18), p = .04, I:9%] while the effect was neutral concerning LVEDV [MD: -3.10 (95% CI -6.76, 0.56), p = .40, I:4%]. LVMi [MD: -3.99 (95% CI -7.16 to -0.82), p = .01, I:65%], LAVi [MD: -1.77 (95% CI -2.97, -0.57), p < .01, I:0%], and E/e' [MD: -1.39 (95% CI -2.04, -0.73), p < .01, I:55%] were significantly reduced.
In this systematic review and meta-analysis, the use of SGLT2 inhibitors was associated with an improvement in markers of cardiac function, confirming the importance of SGLT2 inhibition towards the reversal of cardiac remodeling.
无论左心室射血分数（LVEF）如何以及是否存在糖尿病，使用钠-葡萄糖协同转运蛋白2抑制剂（SGLT2-Is）已给心力衰竭患者带来显著益处。本系统评价和荟萃分析的目的是评估SGLT2-Is对心功能指标的影响。
我们对评估SGLT2-I起始治疗后LVEF、整体纵向应变（GLS）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室质量指数（LVMi）、左心房容积指数（LAVi）和E/e'变化的研究进行了系统的文献检索。
共纳入32项研究，涉及2351例患者。SGLT2抑制使心力衰竭患者的LVEF显著改善[平均差（MD）1.97（95%置信区间0.92，3.02），p <.01，I²：84%]，GLS增加[MD 1.17（95%置信区间0.25，2.10），p <.01]，LVESV降低[MD：-3.60（95%置信区间-7.02，-0.18），p =.04，I²：9%]，而对LVEDV的影响为中性[MD：-3.10（95%置信区间-6.76，0.56），p =.40，I²：4%]。LVMi[MD：-3.99（95%置信区间-7.16至-0.82），p =.01，I²：65%]、LAVi[MD：-1.77（95%置信区间-2.97，-0.57），p <.01，I²：0%]和E/e'[MD：-1.39（95%置信区间-2.04，-0.73），p <.01，I²：55%]均显著降低。
在本系统评价和荟萃分析中，使用SGLT2抑制剂与心功能标志物的改善相关，证实了SGLT2抑制对逆转心脏重塑的重要性。
