Left ventricular remodeling response to SGLT2 inhibitors in heart failure: an updated meta-analysis of randomized controlled studies
Authors' conclusion
Treatment with SGLT2i significantly reversed cardiac volumes, improving LV systolic function and LV mass, particularly in HFrEF patients.
Study context
- Population
- Heart failure (HF) outpatients in randomized controlled trials (RCTs) of SGLT2i
- Participants
- 1,385 outpatients9 RCTs
- Comparison
- SGLT2i vs control
- Outcome
- Change in absolute LV end-diastolic (LVEDV) and end-systolic volume (LVESV)
- Follow-up
- Baseline to study endpoint
Methodological detailsPROSPERO-registered protocol, four electronic databases searched, published until June 2022
- PROSPERO-registered protocol
- Four electronic databases searched, published until June 2022
Pooled result
As reported in the abstract
SGLT2i vs ControlMD, ml (95% CI)P value
LVEDV
−10.59(−17.27 to −3.91)
P = 0.0019LVESV
−8.80(−16.91 to −0.694)
P = 0.0334Further pooled results
| Outcome | MD (gr/m²) (95% CI) | P value | |
|---|---|---|---|
| LVMi | −5.34 (−9.76 to −0.922) | P = 0.0178 | |
| −10−505Difference, gr/m² (linear scale) |
| Outcome | MD (%) (95% CI) | P value |
|---|---|---|
| LVEFEstimate outside printed interval | + 1.98 (0.67–0.306) | P = 0.0031 |
- LV Mass index (LVMi): available in 640
- LV ejection fraction (LVEF): 9 RCTs
Subgroups
- Effect on LVEF did not differ by imaging method, follow-up time or HF phenotype
- Reduction in LV volumes tended to be greater in HF with reduced EF (HFrEF) than HFpEF; opposite for LVMi
Original publication
Left ventricular remodeling response to SGLT2 inhibitors in heart failure: an updated meta-analysis of randomized controlled studies. Cardiovasc Diabetol. Published 2 September 2023. doi:10.
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