PMID- 34792124 OWN - NLM STAT- MEDLINE DCOM- 20220404 LR - 20230325 IS - 2047-4881 (Electronic) IS - 2047-4873 (Linking) VI - 28 IP - 17 DP - 2022 Feb 3 TI - Effect of sodium-glucose cotransporter-2 inhibitors on cardiac remodelling: a systematic review and meta-analysis. PG - 1961-1973 LID - 10.1093/eurjpc/zwab173 [doi] AB - AIMS: To examine the effects of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on cardiac remodelling in patients with type 2 diabetes mellitus (T2DM) and/or heart failure (HF), and to explore the subsets of patients who may have greater benefit from SGLT2i therapy. METHODS AND RESULTS: Four electronic databases were searched for randomized controlled trials (RCTs) that evaluated the effects of SGLT2i on parameters reflecting cardiac remodelling in patients with T2DM and/or HF. Standardized mean differences (SMDs) or mean differences (MDs) were pooled. Subgroup analyses were performed according to the baseline HF and T2DM, HF type, SGLT2i agent, follow-up duration, and imaging modality. A total of 13 RCTs involving 1251 patients were analysed. Sodium-glucose cotransporter-2 inhibitors treatment significantly improved left ventricular (LV) ejection fraction [SMD, 0.35; 95% confidence interval (CI) (0.04, 0.65); P = 0.03], LV mass [SMD, -0.48; 95% CI (-0.79, -0.18); P = 0.002], LV mass index [SMD, -0.27; 95% CI (-0.49, -0.05); P = 0.02], LV end-systolic volume [SMD, -0.37; 95% CI (-0.71; -0.04); P = 0.03], LV end-systolic volume index [MD, -0.35 mL/m2; 95% CI (-0.64, -0.05); P = 0.02], and E-wave deceleration time [SMD, -0.37; 95% CI (-0.70, -0.05); P = 0.02] in the overall population. Subgroup analyses showed that the favourable effects of SGLT2i on LV remodelling were only significant in HF patients, especially HF with reduced ejection fraction (HFrEF), regardless of glycaemic status. Among the four included SGLT2i, empagliflozin was associated with a greater improvement of LV mass, LV mass index, LV end-systolic volume, LV end-systolic volume index, LV end-diastolic volume, and LV end-diastolic volume index (all P < 0.05). CONCLUSIONS: Sodium-glucose cotransporter-2 inhibitors treatment significantly reversed cardiac remodelling, improving LV systolic and diastolic function, LV mass and volume, especially in patients with HFrEF and amongst those taking empagliflozin compared with other SGLT2i. Reversed remodelling may be a mechanism responsible for the favourable clinical effects of SGLT2i on HF. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. FAU - Zhang, Nan AU - Zhang N AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China. FAU - Wang, Yueying AU - Wang Y AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China. FAU - Tse, Gary AU - Tse G AUID- ORCID: 0000-0001-5510-1253 AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China. AD - Kent and Medway Medical School, Canterbury, Kent CT2 7NT, UK. AD - Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, UK. FAU - Korantzopoulos, Panagiotis AU - Korantzopoulos P AD - First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece. FAU - Letsas, Konstantinos P AU - Letsas KP AD - Arrhythmia Unit, Laboratory of Cardiac Pacing and Electrophysiology, Onassis Cardiac Surgery Center, Athens, Greece. FAU - Zhang, Qingpeng AU - Zhang Q AUID- ORCID: 0000-0002-6819-0686 AD - School of Data Science, City University of Hong Kong, Hong Kong, China. FAU - Li, Guangping AU - Li G AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China. FAU - Lip, Gregory Y H AU - Lip GYH AD - Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK. FAU - Liu, Tong AU - Liu T AUID- ORCID: 0000-0003-0482-0738 AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review PL - England TA - Eur J Prev Cardiol JT - European journal of preventive cardiology JID - 101564430 RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) RN - 9NEZ333N27 (Sodium) RN - IY9XDZ35W2 (Glucose) SB - IM CIN - Eur J Prev Cardiol. 2022 Aug 22;29(11):e300-e302. PMID: 34849732 MH - *Diabetes Mellitus, Type 2/complications/diagnosis/drug therapy MH - Glucose/pharmacology/therapeutic use MH - *Heart Failure/complications/diagnosis/drug therapy MH - Humans MH - Sodium/pharmacology/therapeutic use MH - *Sodium-Glucose Transporter 2 Inhibitors/adverse effects MH - Stroke Volume MH - Ventricular Remodeling OTO - NOTNLM OT - Cardiac remodelling OT - HFrEF OT - Heart failure OT - Sodium-glucose cotransporter-2 inhibitors OT - Type 2 diabetes mellitus EDAT- 2021/11/19 06:00 MHDA- 2022/04/05 06:00 CRDT- 2021/11/18 08:51 PHST- 2021/08/10 00:00 [received] PHST- 2021/10/04 00:00 [accepted] PHST- 2021/11/19 06:00 [pubmed] PHST- 2022/04/05 06:00 [medline] PHST- 2021/11/18 08:51 [entrez] AID - 6430917 [pii] AID - 10.1093/eurjpc/zwab173 [doi] PST - ppublish SO - Eur J Prev Cardiol. 2022 Feb 3;28(17):1961-1973. doi: 10.1093/eurjpc/zwab173.