Abstract：
OBJECTIVE: The therapeutic mechanism of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on left cardiac remodelling in patients with heart failure with reduced ejection fraction (HFrEF) is not well-established. This study meta-analysed the impact of SGLT2i on left cardiac structure and function in patients with HFrEF.
RESULTS: Online databases were queried up to April 2023 for trials reporting indicators of left cardiac structure and function in patients with HFrEF treated with SGLT2i. Data from studies were pooled using a random-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs). Six trials were included (n = 555). Compared with control, SGLT2i significantly improved left ventricular end-diastolic volume (LVEDV; WMD: -17.07 ml [-23.84, -10.31]; p < 0.001), LVEDV index (WMD: -5.62 ml/m2 [-10.28, -0.97]; p = 0.02), left ventricular end-systolic volume (LVESV; WMD: -15.63 ml [-26.15, -5.12]; p = 0.004), LVESV index (WMD: -6.90 ml/m2 [-10.68, -3.11]; p = 0.001), left ventricular ejection fraction (WMD: 2.71% [0.70, 4.72]; p = 0.008), and left atrial volume index (WMD: -2.19 ml/m2 [-4.26, -0.11]; p = 0.04) in patients with HFrEF. SGLT2i use was associated with a non-significant trend towards a reduction in left ventricular mass index (WMD: -6.25 g/m2 [-12.79, 0.28]; p = 0.06). No significant impact on left ventricular global longitudinal strain was noted (WMD: 0.21% [-0.25, 0.67]; p = 0.38).
CONCLUSIONS: Sodium-glucose cotransporter 2 inhibitors improve cardiac structure and function in patients with HFrEF.
RESULTS: Online databases were queried up to April 2023 for trials reporting indicators of left cardiac structure and function in patients with HFrEF treated with SGLT2i. Data from studies were pooled using a random-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs). Six trials were included (n = 555). Compared with control, SGLT2i significantly improved left ventricular end-diastolic volume (LVEDV; WMD: -17.07 ml [-23.84, -10.31]; p < 0.001), LVEDV index (WMD: -5.62 ml/m2 [-10.28, -0.97]; p = 0.02), left ventricular end-systolic volume (LVESV; WMD: -15.63 ml [-26.15, -5.12]; p = 0.004), LVESV index (WMD: -6.90 ml/m2 [-10.68, -3.11]; p = 0.001), left ventricular ejection fraction (WMD: 2.71% [0.70, 4.72]; p = 0.008), and left atrial volume index (WMD: -2.19 ml/m2 [-4.26, -0.11]; p = 0.04) in patients with HFrEF. SGLT2i use was associated with a non-significant trend towards a reduction in left ventricular mass index (WMD: -6.25 g/m2 [-12.79, 0.28]; p = 0.06). No significant impact on left ventricular global longitudinal strain was noted (WMD: 0.21% [-0.25, 0.67]; p = 0.38).
CONCLUSIONS: Sodium-glucose cotransporter 2 inhibitors improve cardiac structure and function in patients with HFrEF.
摘要：
目的：钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）对射血分数降低（HFrEF）的心力衰竭患者左心重塑的治疗机制尚不明确。这项研究荟萃分析了SGLT2i对HFrEF患者左心结构和功能的影响。
结果：在2023年4月之前，在线数据库中查询了报告SGLT2i治疗HFrEF患者左心结构和功能指标的试验。使用随机效应模型汇总研究数据，以得出加权平均差（WMD）和95％置信区间（CI）。纳入6项试验（n=555）。与对照相比，SGLT2i显著改善左心室舒张末期容积(LVEDV;WMD:-17.07ml[-23.84,-10.31];p<0.001),LVEDV指数(WMD:-5.62ml/m2[-10.28,-0.97];p=0.02),左心室收缩末期容积(LVESV;WMD:-15.63ml[-26.15,-5.12];p=0.004),LVESV指数（WMD：-6.90ml/m2[-10.68，-3.11]；p=0.001），左心室射血分数(WMD:2.71%[0.70,4.72];p=0.008),HFrEF患者的左心房容积指数（WMD：-2.19ml/m2[-4.26，-0.11]；p=0.04）。SGLT2i的使用与左心室质量指数降低的趋势无关(WMD:-6.25g/m2[-12.79,0.28];p=0.06)。对左心室整体纵向应变无显著影响(WMD:0.21%[-0.25,0.67];p=0.38)。
结论：钠-葡萄糖协同转运蛋白2抑制剂可改善HFrEF患者的心脏结构和功能。
结果：在2023年4月之前，在线数据库中查询了报告SGLT2i治疗HFrEF患者左心结构和功能指标的试验。使用随机效应模型汇总研究数据，以得出加权平均差（WMD）和95％置信区间（CI）。纳入6项试验（n=555）。与对照相比，SGLT2i显著改善左心室舒张末期容积(LVEDV;WMD:-17.07ml[-23.84,-10.31];p<0.001),LVEDV指数(WMD:-5.62ml/m2[-10.28,-0.97];p=0.02),左心室收缩末期容积(LVESV;WMD:-15.63ml[-26.15,-5.12];p=0.004),LVESV指数（WMD：-6.90ml/m2[-10.68，-3.11]；p=0.001），左心室射血分数(WMD:2.71%[0.70,4.72];p=0.008),HFrEF患者的左心房容积指数（WMD：-2.19ml/m2[-4.26，-0.11]；p=0.04）。SGLT2i的使用与左心室质量指数降低的趋势无关(WMD:-6.25g/m2[-12.79,0.28];p=0.06)。对左心室整体纵向应变无显著影响(WMD:0.21%[-0.25,0.67];p=0.38)。
结论：钠-葡萄糖协同转运蛋白2抑制剂可改善HFrEF患者的心脏结构和功能。
