Vetrano Erica, Galiero Raffaele, Simeon Vittorio, Palmiero Giuseppe, Cesaro Arturo, Caturano Alfredo, Rinaldi Luca, Salvatore Teresa, Ruggiero Roberto, Di Palo Maria Rosaria, Sardu Celestino, Marfella Raffaele, Calabrò Paolo, Sasso Ferdinando Carlo
Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy.
Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, Italy.
Pharmaceuticals (Basel). 2025 Aug 14;18(8):1200. doi: 10.3390/ph18081200.
: The effect of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in addition to optimal medical therapy (OMT) on right ventricular (RV) systolic function in patients with heart failure with reduced ejection fraction (HFrEF) is not well established. This study aimed to assess the impact of SGLT2is on RV function using advanced echocardiographic parameters in patients with HFrEF and type 2 diabetes (T2D). : The real-world prospective, observational GLISCAR study enrolled 31 consecutive patients with T2D and HFrEF. All participants underwent clinical evaluation, laboratory testing, and comprehensive echocardiography at baseline and after 12 months of treatment with an SGLT2i. : After 12 months, statistically significant improvements in RV function were observed. Tricuspid annular plane systolic excursion (TAPSE) increased from 18.00 mm (SD ± 4.23; 95% confidence interval (CI): 16.51-19.49 mm) to 19.40 mm (SD ± 4.13; 95% CI: 17.95-20.85 mm) ( = 0.0346), and pulmonary artery systolic pressure (PASP) decreased from 35.23 mmHg (SD ± 14.61; 95% CI: 30.09-40.37 mm) to 30.89 mmHg (SD ± 7.77; 95% CI: 28.15-33.63 mm) ( < 0.001). These changes may suggest favorable RV remodeling and improved right ventricular-arterial coupling (RVAC). : SGLT2i therapy was associated with improved RV function and RVAC in patients with HFrEF and T2D. While these findings are preliminary and drawn from a small, observational cohort, they support a potential role for SGLT2is in right heart remodeling. Further randomized, controlled studies are needed to confirm these effects and clarify their clinical implications.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）联合优化药物治疗（OMT）对射血分数降低的心力衰竭（HFrEF）患者右心室（RV）收缩功能的影响尚不明确。本研究旨在使用先进的超声心动图参数评估SGLT2i对HFrEF合并2型糖尿病（T2D）患者RV功能的影响。：真实世界前瞻性观察性GLISCAR研究连续纳入了31例T2D合并HFrEF患者。所有参与者在基线时以及接受SGLT2i治疗12个月后均接受了临床评估、实验室检查和全面的超声心动图检查。：12个月后，观察到RV功能有统计学意义的改善。三尖瓣环平面收缩期位移（TAPSE）从18.00毫米（标准差±4.23；95%置信区间（CI）：16.51 - 19.49毫米）增加到19.40毫米（标准差±4.13；95%CI：17.95 - 20.85毫米）（P = 0.0346），肺动脉收缩压（PASP）从35.23毫米汞柱（标准差±14.61；95%CI：30.09 - 40.37毫米）降至30.89毫米汞柱（标准差±7.77；95%CI：28.15 - 33.63毫米）（P < 0.001）。这些变化可能提示有利的RV重塑和右心室-动脉耦联（RVAC）改善。：SGLT2i治疗与HFrEF合并T2D患者的RV功能和RVAC改善相关。虽然这些发现是初步的，且来自一个小型观察性队列，但它们支持SGLT2i在右心重塑中可能发挥的作用。需要进一步的随机对照研究来证实这些效应并阐明其临床意义。
