Left ventricular remodeling response to SGLT2 inhibitors in heart failure: an updated meta-analysis of randomized controlled studies.
Left ventricular remodeling response to SGLT2 inhibitors in heart failure: an updated meta-analysis of randomized controlled studies.
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DOI：
10.1186/s12933-023-01970-w
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发表时间：
2023-09-02
影响因子：
9.3
通讯作者：
Ambrosio, Giuseppe
中科院分区：
文献类型：
--
作者：
Carluccio, Erberto;Biagioli, Paolo;Reboldi, Gianpaolo;Mengoni, Anna;Lauciello, Rosanna;Zuchi, Cinzia;D'Addario, Sandra;Bardelli, Giuliana;Ambrosio, Giuseppe
随机对照试验(RCT)报道了心力衰竭(HF)患者钠-葡萄糖共转运体-2抑制剂(SGLT2I)治疗后逆转左室重构(LVR)的对比结果。我们对发表至2022年6月的心力衰竭门诊患者SGLT2i治疗的随机对照试验进行了荟萃分析，检索了四个电子数据库。该方案已发表在《普罗斯佩罗》上。主要的LVR结果是从基线到研究终点的绝对LV舒张期末期(LVEDV)和收缩末期容量(LVESV)的变化。次要结果包括以体表面积为指标的LVEDV和LVESV、LV质量指数(LVMi)、LV射血分数(LVEF)和N端前B型利钠肽(NTproBNP)的变化。合并95%CI的平均差值(MD)。共分析了9个随机对照试验(1385例患者)。所有人都报告了左心室射血分数的数据。有6项试验报告了有关左心室收缩末期血流速度和左心室舒张期血流速度的数据(n = 951)；SGLT2i治疗后左室舒张功能明显降低[MD=-10.59ml(-17.27；-3.91)，P = 0.0019]、LVESV[MD=-8.80ml(-16.91；-0.694)，P = 0.0334]和左心室指数[MD=-5.34gr/m2(-9.76；-0.922)，P = 0.0178]，而左心室射血分数显著升高[MD = + 1.98%(0.67；0.306)，P = 0.0031]。通过亚组分析，SGLT2i对LVEF的有利影响不同于所使用的成像方法、随访再评估时间或HF表型。EF降低的HF患者(HFrEF)比EF保留的患者(HFpEF)的LV容量减少更明显，而LVMi的情况则相反。SGLT2i治疗显著逆转了心脏容量，改善了左心室收缩功能和左心室重量，特别是在HFrEF患者。网上版载有补充材料，可在10.1186/s12933-023-01970-w查阅。
Randomized controlled trials (RCTs) reported contrasting results about reverse left ventricular remodeling (LVR) after sodium-glucose co-transporter-2 inhibitors (SGLT2i) therapy in patients with heart failure (HF). We performed a metanalysis of RCTs of SGLT2i administration in HF outpatients published until June 2022 searching four electronic databases. The protocol has been published in PROSPERO. Primary LVR outcome was change in absolute LV end-diastolic (LVEDV) and end-systolic volume (LVESV) from baseline to study endpoint. Secondary outcomes included changes in LVEDV and LVESV indexed to body surface area, LV Mass index (LVMi), LV ejection fraction (LVEF), and N-terminal pro-B-type natriuretic peptide (NTproBNP). Mean differences (MDs) with 95% CIs were pooled. A total of 9 RCTs (1385 patients) were analyzed. All of them reported data on LVEF. Six trials reported data on LVESV and LVEDV (n = 951); LVMi was available in 640. SGLT2i treatment significantly reduced LVEDV [MD= -10.59 ml (-17.27; -3.91), P = 0.0019], LVESV [MD= -8.80 ml (-16.91; -0.694), P = 0.0334], and LVMI [MD= -5.34 gr/m2 (-9.76; -0.922), P = 0.0178], while LVEF significantly increased [MD = + 1.98% (0.67; 0.306), P = 0.0031]. By subgroup analysis, the beneficial effects of SGLT2i on LVEF did not differ by imaging method used, time to follow-up re-evaluation, or HF phenotype. Reduction in LV volumes tended to be greater in HF with reduced EF (HFrEF) than in those with preserved EF (HFpEF), while the opposite was observed for LVMi. Treatment with SGLT2i significantly reversed cardiac volumes, improving LV systolic function and LV mass, particularly in HFrEF patients. The online version contains supplementary material available at 10.1186/s12933-023-01970-w.
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影响因子：
37.8
作者：
Lee MMY;Brooksbank KJM;Wetherall K;Mangion K;Roditi G;Campbell RT;Berry C;Chong V;Coyle L;Docherty KF;Dreisbach JG;Labinjoh C;Lang NN;Lennie V;McConnachie A;Murphy CL;Petrie CJ;Petrie JR;Speirits IA;Sourbron S;Welsh P;Woodward R;Radjenovic A;Mark PB;McMurray JJV;Jhund PS;Petrie MC;Sattar N
通讯作者：
Sattar N
影响因子：
9.3
作者：
Rau M;Thiele K;Hartmann NK;Schuh A;Altiok E;Möllmann J;Keszei AP;Böhm M;Marx N;Lehrke M
通讯作者：
Lehrke M
影响因子：
9.7
作者：
Juni, Rio P.;Kuster, Diederik W. D.;van Hinsbergh, Victor W. M.
通讯作者：
van Hinsbergh, Victor W. M.
影响因子：
158.5
作者：
Solomon, S. D.;McMurray, J. J., V;Langkilde, A. M.
通讯作者：
Langkilde, A. M.
影响因子：
39.3
作者：
Brown AJM;Gandy S;McCrimmon R;Houston JG;Struthers AD;Lang CC
通讯作者：
Lang CC