Kusi-Yeboah Tabitha, Gianfrancesco Isaac, Jabbar Muzammil Arif Din Abdul, Collins Phoebe, Bally Dalton James, Thornton Juliet, Williams Kieran, Ishola Ayoola, Hong Lucy, Toong Ping Jing, Wickramarachchi Milindu
Clinical School, University of Cambridge, Cambridge, United Kingdom.
Clinical School, University College London, London, United Kingdom.
Front Cardiovasc Med. 2025 Jul 4;12:1556606. doi: 10.3389/fcvm.2025.1556606. eCollection 2025.
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have emerged as an integral component of heart failure management, with evidence supporting their benefits across a broad spectrum of ejection fractions. However, their impact on quality of life (QoL) in patients with heart failure with mildly reduced (HFmrEF) and preserved ejection fraction (HFpEF) remains underexplored. This systematic review and meta-analysis aim to evaluate the effects of SGLT2i on QoL compared to standard therapy in these patient populations.
A systematic search of PubMed, Cochrane, and EMBASE databases was conducted for randomized controlled trials (RCTs) published in English that assessed the clinical outcomes of SGLT2i in HFpEF and HFmrEF up to January 23, 2024. Two independent reviewers evaluated the risk of bias for eligible studies. A random-effects model was used for meta-analysis. The primary outcomes of interest were changes in the Kansas City Cardiomyopathy Questionnaire (KCCQ) score and 6 Minute Walk Test Distance (6MWTD).
A total of 7 RCTs comparing KCCQ score in HFpEF and HFmrEF in participants receiving SGLT2i vs. placebo, and 3 RCTs comparing 6MWTD in HFpEF and HFmrEF in participants receiving SGLT2i vs. placebo were included in the systematic review. Overall SGLT2i was associated with an increase in KCCQ-TSS score (MD = 2.28, 95% CI 1.94-2.63, = 0%) and 6MWTD (MD = 13.52, 95% CI 1.70-25.34, = 62%).
These findings suggest that SGLT2i not only confer cardiovascular benefits but also enhance patient-reported health status, reinforcing their role as a valuable adjunct to standard heart failure therapy in HFmrEF and HFpEF.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）已成为心力衰竭管理的重要组成部分，有证据支持其在广泛射血分数范围内的益处。然而，它们对轻度射血分数降低（HFmrEF）和射血分数保留（HFpEF）的心力衰竭患者生活质量（QoL）的影响仍未得到充分研究。本系统评价和荟萃分析旨在评估SGLT2i与标准治疗相比对这些患者群体生活质量的影响。
对PubMed、Cochrane和EMBASE数据库进行系统检索，查找截至2024年1月23日以英文发表的评估SGLT2i在HFpEF和HFmrEF中临床结局的随机对照试验（RCT）。两名独立 reviewers 评估符合条件研究的偏倚风险。采用随机效应模型进行荟萃分析。感兴趣的主要结局是堪萨斯城心肌病问卷（KCCQ）评分和6分钟步行试验距离（6MWTD）的变化。
系统评价纳入了7项比较接受SGLT2i与安慰剂的HFpEF和HFmrEF参与者KCCQ评分的RCT，以及3项比较接受SGLT2i与安慰剂的HFpEF和HFmrEF参与者6MWTD的RCT。总体而言，SGLT2i与KCCQ-TSS评分增加（MD = 2.28，95%CI 1.94 - 2.63，I² = 0%）和6MWTD增加（MD = 13.52，95%CI 1.70 - 25.34，I² = 62%）相关。
这些发现表明，SGLT2i不仅具有心血管益处，还能改善患者报告的健康状况，强化了它们在HFmrEF和HFpEF中作为标准心力衰竭治疗有价值辅助手段的作用。
