Department of Medicine, University of Maryland Midtown Campus, Baltimore, Maryland, United States.
Department of Cardiology, Health Sciences University, Van Training and Research Hospital, Istanbul, Turkey.
Kardiol Pol. 2024;82(4):416-422. doi: 10.33963/v.phj.100199. Epub 2024 Apr 19.
There is some discrepancy in current studies concerning the effect of sodium-glucose cotransporter type 2 inhibitors (SGLT2i) on right ventricular (RV) functions in heart failure (HF) patients. Hence, this meta-analysis was focused on determining the impact of SGLT2i on RV functions in such individuals.
Two independent investigators searched PubMed, Google Scholar, and the Cochrane Library for articles of interest. To analyze heterogeneity, Higgins' I2 as well as prediction intervals and Egger's test were used to assess heterogeneity. The Newcastle-Ottawa standard ratings approach was used to assess the quality of observational studies. The ROBINS-I risk of bias algorithm was used to assess bias risks of randomized studies.
This meta-analysis evaluated 8 studies in total. Over the follow-up time frame, patients who used SGLT2i had substantially lower systolic pulmonary artery pressure and higher tricuspid annular plane systolic excursion values (mean difference [MD] = -5.23 [-7.81; -2.66] and, MD = 1.47 [1.01; 1.93]; P <0.01, respectively). There was no significant difference in RVS' values between follow-up and baseline (MD = 1.54 [-0.19; 3.26]; P = 0.08). However, as compared to the baseline period, fractional area contraction values were substantially larger at the end of the follow-up (MD = 5.52 [4.23; 6.82]; P <0.01).
To the best of our knowledge, this is the first meta-analysis assessing the impact of SGLT2i on RV function in HF patients. Our findings suggest that SGLT2i may improve RV performance in HF patients.
目前关于钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）对心力衰竭（HF）患者右心室（RV）功能的影响的研究结果存在差异。因此，本荟萃分析旨在确定 SGLT2i 对这类人群 RV 功能的影响。
两名独立的研究者检索了 PubMed、Google Scholar 和 Cochrane 图书馆中的相关文章。为了分析异质性，采用 Higgins' I2 以及预测区间和 Egger 检验来评估异质性。采用纽卡斯尔-渥太华量表评价观察性研究的质量。采用 ROBINS-I 偏倚风险算法评估随机研究的偏倚风险。
本荟萃分析共评估了 8 项研究。在随访期间，使用 SGLT2i 的患者的收缩期肺动脉压显著降低，三尖瓣环平面收缩期位移值显著升高（平均差异 [MD] = -5.23 [-7.81; -2.66] 和 MD = 1.47 [1.01; 1.93]；P <0.01）。随访与基线之间 RV 应变值无显著差异（MD = 1.54 [-0.19; 3.26]；P = 0.08）。然而，与基线期相比，随访期末的节段面积收缩率显著增大（MD = 5.52 [4.23; 6.82]；P <0.01）。
据我们所知，这是第一项评估 SGLT2i 对 HF 患者 RV 功能影响的荟萃分析。我们的研究结果表明，SGLT2i 可能改善 HF 患者的 RV 功能。
