Sodium-glucose cotransporter 2 inhibitors may improve left ventricular diastolic function in hypertrophic cardiomyopathy
1. Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) were associated with improved left ventricular diastolic function and New York Heart Association (NYHA) class in patients with hypertrophic cardiomyopathy (HCM).
Evidence Rating Level: 2 (Good)
Current management of HCM includes symptom control with beta-blockers and calcium channel blockers, and risk reduction through invasive procedures such as septal reduction therapy and implantable cardioverter-defibrillators. SGLT-2i have been shown to have strong cardioprotective properties in heart failure; however, these pivotal trials excluded patients with HCM. This single-center retrospective cohort study included patients aged 18 or older with HCM and no prior exposure to SGLT-2i. After propensity score-matching, 188 patients were included. 94 patients (mean [SD] age, 69.0 [14.0] years; 34% female) were started on an SGLT-2i during admission, and 94 patients (mean [SD] age, 65.4 [14.8] years; 30.9% female) were not. The primary endpoints were mitral annular tissue velocity (e′), early diastolic mitral inflow velocity (E)/e′, interventricular septal thickness (IVST), and NYHA class. At 6-months, the SGLT-2i group exhibited significantly greater improvements in septal e′ (0.7 ± 1.3 vs. Δ0.04 ± 1.6, p = 0.002), E/e′ (–5.1 ± 8.7 vs. 0.4 ± 6.4, p < 0.001), IVST (–1.3 (–3.1 to 0) mm vs. −0.2 (–2.0 to 0.9) mm, p = 0.005), NYHA class (−1(−1 to −0.25) vs. −1 (−1 to 0), p = 0.031), and BNP levels (0 (–607.5 to 0) pg/mL vs. 0 (–105.7 to 0) pg/mL, p = 0.023). No hypoglycemia and urinary tract infection events were recorded in either group, and no significant changes in creatinine were observed (2.3 ± 15.7 vs. 0.3 ± 15.4 mg/dL, p = 0.38).
Click here to read this study in Frontiers in Cardiovascular Medicine
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