PDF(Pubmed)
Abstract：
UNASSIGNED: Advanced heart failure (HF) is an epidemic that affects multiple organ systems with high morbidity and mortality rates despite optimal medical therapy (OMT) and remains the leading cause of hospitalizations in type 2 diabetes-related cardiovascular disease. The addition of sodium-glucose co-transporter inhibitors (SGLT2i) in treating these patients has seen improved mortality and hospital admission rates. As such, we felt it was important to investigate whether the use of SGLT2i improved functional capacity in patients with HF when compared to OMT by evaluating maximum oxygen consumption (peak VO2) using cardiopulmonary exercise testing (CPET).
UNASSIGNED: We found 94 heart failure patients between August 2020 and August 2021 who underwent CPET before and after treatment at Mayo Clinic in Florida. 50 patients received OMT and 44 received OMT and SGLT2i therapy. CPET results before and after were compared for each group.
UNASSIGNED: The baseline ejection fraction was not significantly different between groups, with the OMT group at 38% and the SGLT2i group at 33%, p = 0.10. OMT patients were found to have a significantly lower hemoglobin A1c of 5.7 (5.4-6.1) compared to those with SGLT2i therapy of 6.4 (5.8-7.1), p = 0.01. The baseline peak VO2 was 17.3 ml/kg/min (13.3-21.6) in the OMT group and 17.3 ml/kg/min (14.4-18.9) in the SGLT2i group, p = 0.18, not significantly different. The interesting finding is that the follow-up peak VO2 at one year for the OMT group was 17 ml/kg/min (13.3-21.6), which was not significantly different from the SGLT2i group peak VO2 of 17 ml/kg/min (14.6-19.6), p = 0.19. Our study is the first to compare before and after peak VO2 values of the OMT+SGLT2i group to the patient\'s own baseline and we found no significant improvement.
UNASSIGNED: Our single-center data shows no improvement in functional capacity after the addition of SGLT2i therapy to OMT in patients with advanced heart failure. Improved hospitalization and symptoms may be attributed to other numerous effects of SGLT2i such as volume management.
UNASSIGNED: We found 94 heart failure patients between August 2020 and August 2021 who underwent CPET before and after treatment at Mayo Clinic in Florida. 50 patients received OMT and 44 received OMT and SGLT2i therapy. CPET results before and after were compared for each group.
UNASSIGNED: The baseline ejection fraction was not significantly different between groups, with the OMT group at 38% and the SGLT2i group at 33%, p = 0.10. OMT patients were found to have a significantly lower hemoglobin A1c of 5.7 (5.4-6.1) compared to those with SGLT2i therapy of 6.4 (5.8-7.1), p = 0.01. The baseline peak VO2 was 17.3 ml/kg/min (13.3-21.6) in the OMT group and 17.3 ml/kg/min (14.4-18.9) in the SGLT2i group, p = 0.18, not significantly different. The interesting finding is that the follow-up peak VO2 at one year for the OMT group was 17 ml/kg/min (13.3-21.6), which was not significantly different from the SGLT2i group peak VO2 of 17 ml/kg/min (14.6-19.6), p = 0.19. Our study is the first to compare before and after peak VO2 values of the OMT+SGLT2i group to the patient\'s own baseline and we found no significant improvement.
UNASSIGNED: Our single-center data shows no improvement in functional capacity after the addition of SGLT2i therapy to OMT in patients with advanced heart failure. Improved hospitalization and symptoms may be attributed to other numerous effects of SGLT2i such as volume management.
摘要：
晚期心力衰竭（HF）是一种流行病，尽管采用最佳药物治疗（OMT），但仍影响多器官系统，发病率和死亡率很高，并且仍然是2型糖尿病相关心血管疾病住院的主要原因。在治疗这些患者中添加钠-葡萄糖协同转运蛋白抑制剂(SGLT2i)已经看到改善的死亡率和住院率。因此，我们认为,通过使用心肺运动试验(CPET)评估最大耗氧量(峰值VO2),与OMT相比,研究使用SGLT2i是否能改善HF患者的功能能力非常重要.
我们在2020年8月至2021年8月期间发现了94名心力衰竭患者，他们在佛罗里达州梅奥诊所接受了CPET治疗前后。50例患者接受OMT治疗，44例患者接受OMT和SGLT2i治疗。比较各组前后的CPET结果。
■两组之间的基线射血分数没有显着差异，OMT组为38%，SGLT2i组为33%，p=0.10。与SGLT2i治疗6.4（5.8-7.1）相比，OMT患者的血红蛋白A1c显着降低，为5.7（5.4-6.1），p=0.01。OMT组VO2基线峰值为17.3ml/kg/min(13.3-21.6),SGLT2i组VO2基线峰值为17.3ml/kg/min(14.4-18.9),p=0.18，差别不明显。有趣的发现是，OMT组一年的随访峰值VO2为17ml/kg/min（13.3-21.6），与SGLT2i组峰值VO217ml/kg/min(14.6-19.6)无显著差异,p=0.19。我们的研究首次将OMT+SGLT2i组前后的峰值VO2值与患者自身的基线进行比较，我们没有发现显著的改善。
■我们的单中心数据显示，在晚期心力衰竭患者中，在OMT中添加SGLT2i治疗后，功能能力没有改善。住院和症状的改善可能归因于SGLT2i的其他许多作用，例如容量管理。
我们在2020年8月至2021年8月期间发现了94名心力衰竭患者，他们在佛罗里达州梅奥诊所接受了CPET治疗前后。50例患者接受OMT治疗，44例患者接受OMT和SGLT2i治疗。比较各组前后的CPET结果。
■两组之间的基线射血分数没有显着差异，OMT组为38%，SGLT2i组为33%，p=0.10。与SGLT2i治疗6.4（5.8-7.1）相比，OMT患者的血红蛋白A1c显着降低，为5.7（5.4-6.1），p=0.01。OMT组VO2基线峰值为17.3ml/kg/min(13.3-21.6),SGLT2i组VO2基线峰值为17.3ml/kg/min(14.4-18.9),p=0.18，差别不明显。有趣的发现是，OMT组一年的随访峰值VO2为17ml/kg/min（13.3-21.6），与SGLT2i组峰值VO217ml/kg/min(14.6-19.6)无显著差异,p=0.19。我们的研究首次将OMT+SGLT2i组前后的峰值VO2值与患者自身的基线进行比较，我们没有发现显著的改善。
■我们的单中心数据显示，在晚期心力衰竭患者中，在OMT中添加SGLT2i治疗后，功能能力没有改善。住院和症状的改善可能归因于SGLT2i的其他许多作用，例如容量管理。
