Nan Geli, Yang Cui Bing, Jia Zhi Kun
Department of Ultrasonography, Xi'an Gaoxin Hospital, Yanta District, Xi'an, China.
Department of Cardiology, Shuyang Minghe Hospital, Shuyang County, Suqian, China.
Postepy Kardiol Interwencyjnej. 2025 May 27;21(2):146-154. doi: 10.5114/aic.2025.151600. eCollection 2025 Jun.
Empagliflozin was shown to improve the clinical outcomes of cardiovascular diseases; however, its effects on cardiac structure and cardiac remodeling in patients with heart failure remain controversial to some extent.
We conducted this meta-analysis to compare the effect of empagliflozin with placebo on cardiac structure and function among patients with heart failure.
PubMed, Scopus, Web of Science, and the Cochrane Library were systematically searched from inception to December 20, 2024, to identify randomized controlled trials comparing the effects of empagliflozin with placebo on cardiac structure and function in patients with heart failure. A random-effects model (DerSimonian-Laird) was employed to pool data.
Four studies with 234 individuals in the empagliflozin group and 231 individuals in the placebo group were included. Compared to placebo, empagliflozin 10 (mg/day) significantly increased left ventricular ejection fraction (LVEF) (WMD 2.96%, 95% CI (0.84, 5.09), = 85.28%), decreased left ventricular (LV) end-diastolic volume (WMD -17.05 ml, 95% CI (-23.68, -10.42), = 13.88%), LV end-diastolic volume index (WMD -7.59 ml/m, 95% CI (-10.08, -5.10), = 0.00%), LV end-systolic volume (WMD -15.59 ml, 95% CI (-25.89, -5.28), = 74.69%), LV end-systolic volume index (WMD -6.68 ml/m, 95% CI (-7.95, -5.41), = 0.00%), and left atrial volume index (WMD -2.16 ml/m, 95% CI (-4.21, -0.10), = 0.00%), but did not significantly change LV mass (WMD -11.66 g, 95% CI (-30.54, 7.22), = 90.02%) and LV mass index (WMD -4.01 g/m, 95% CI (-10.94, 2.92), = 64.29%).
Empagliflozin can significantly improve myocardial function and prevent myocardial remodeling in patients with heart failure.
恩格列净已被证明可改善心血管疾病的临床结局；然而，其对心力衰竭患者心脏结构和心脏重塑的影响在一定程度上仍存在争议。
我们进行这项荟萃分析，以比较恩格列净与安慰剂对心力衰竭患者心脏结构和功能的影响。
从数据库建立至2024年12月20日，系统检索了PubMed、Scopus、Web of Science和Cochrane图书馆，以确定比较恩格列净与安慰剂对心力衰竭患者心脏结构和功能影响的随机对照试验。采用随机效应模型（DerSimonian-Laird）合并数据。
纳入了4项研究，恩格列净组有234例个体，安慰剂组有231例个体。与安慰剂相比，10mg/天的恩格列净显著增加左心室射血分数（LVEF）（加权均数差[WMD]为2.96%，95%置信区间[CI]为[0.84, 5.09]，P = 85.28%），降低左心室（LV）舒张末期容积（WMD为-17.05ml，95%CI为[-23.68, -10.42]，P = 13.88%）、LV舒张末期容积指数（WMD为-7.59ml/m²，95%CI为[-10.08, -5.10]，P = 0.00%）、LV收缩末期容积（WMD为-15.59ml，95%CI为[-25.89, -5.28]，P = 74.69%）、LV收缩末期容积指数（WMD为-6.68ml/m²，95%CI为[-7.95, -5.41]，P = 0.00%）和左心房容积指数（WMD为-2.16ml/m²，95%CI为[-4.21, -0.10]，P = 0.00%），但未显著改变LV质量（WMD为-11.66g，95%CI为[-30.54, 7.22]，P = 90.02%）和LV质量指数（WMD为-4.01g/m²，95%CI为[-10.94, 2.92]，P = 64.29%）。
恩格列净可显著改善心力衰竭患者的心肌功能并预防心肌重塑。
