Sridharan Kannan, Sivaramakrishnan Gowri
Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
Dental Post Graduate Training Department, PHCC, Manama, Kingdom of Bahrain.
Curr Rev Clin Exp Pharmacol. 2025 Jun 16. doi: 10.2174/0127724328337478250604061355.
Sodium-glucose Co-transporter-2 Inhibitors (SGLT2is) are recommended for heart failure based on clinical outcomes. However, there is a lack of evidence linking SGLT2is with changes in cardiac function parameters.
This study aimed to systematically evaluate the literature assessing the impact of SGLT2is on various cardiac parameters.
Randomized clinical trials assessing any of the cardiac function parameters (atrial, valvular, pulmonary artery, and left ventricular) with SGLT2is were included. Mixed treatment comparison pooled estimates (mean differences (MD); 95% confidence intervals (95% CI)) were generated using a random-effects model and validated using trial sequential and bootstrap analyses. Intraclass differences and sub-group analysis in heart failure were evaluated.
Thirty-four studies (2930 participants) were included in the review, of which 31 (2616 participants) were included in the meta-analysis. SGLT2is were associated with a significant increase in left ventricular ejection fraction (MD: 0.73; 95% CI: 0.09, 1.37%) and reductions in left ventricular mass (MD: -0.21; 95% CI: -0.39, -0.03 g), left ventricular mass index (MD: -0.22; 95% CI: - 0.36, -0.08 g/m2), left ventricular end-diastolic diameter (MD: -0.71; 95% CI: -1.29, -0.13 cm), left ventricular end-diastolic volume (MD: -0.56; 95% CI: -1.02, -0.1 ml), left atrial volume index (MD: -0.35; 95% CI: -0.58, -0.04 ml/m²), and pulmonary artery systolic pressure (MD: -1.08; 95% CI: - 1.94, -0.21 mmHg). Significant improvements in various cardiac parameters were observed in studies conducted on heart failure.
The findings of this study assessing cardiac function parameters support the guidelines recommending SGLT2 inhibitors in heart failure, which are primarily based on clinical outcomes.
基于临床结局，钠-葡萄糖协同转运蛋白2抑制剂（SGLT2is）被推荐用于治疗心力衰竭。然而，缺乏证据表明SGLT2is与心脏功能参数的变化有关。
本研究旨在系统评价评估SGLT2is对各种心脏参数影响的文献。
纳入评估SGLT2is对任何心脏功能参数（心房、瓣膜、肺动脉和左心室）影响的随机临床试验。采用随机效应模型生成混合治疗比较汇总估计值（平均差（MD）；95%置信区间（95%CI）），并通过试验序贯分析和自助法分析进行验证。评估心力衰竭中的组内差异和亚组分析。
本综述纳入了34项研究（2930名参与者），其中31项研究（2616名参与者）纳入了荟萃分析。SGLT2is与左心室射血分数显著增加（MD：0.73；95%CI：0.09，1.37%）以及左心室质量（MD：-0.21；95%CI：-0.39，-0.03 g）、左心室质量指数（MD：-0.22；95%CI：-0.36，-0.08 g/m²）、左心室舒张末期直径（MD：-0.71；95%CI：-1.29，-0.13 cm）、左心室舒张末期容积（MD：-0.56；95%CI：-1.02，-0.1 ml）、左心房容积指数（MD：-0.35；95%CI：-0.58，-0.04 ml/m²）和肺动脉收缩压（MD：-1.08；95%CI：-1.94，-0.21 mmHg）的降低有关。在针对心力衰竭开展的研究中观察到各种心脏参数有显著改善。
本研究评估心脏功能参数的结果支持主要基于临床结局在心力衰竭中推荐使用SGLT2抑制剂的指南。
