The following is the summary of “Efficacy of SGLT2 Inhibitors in Patients With Diabetes and Nonobstructive Hypertrophic Cardiomyopathy” published in the February 2023 issue of Cardiovascular Disease by Subramanian, et al.
The purpose of this research was to examine how individuals with diabetes and nonobstructive hypertrophic cardiomyopathy (nHCM) who had retained left ventricular (LV) function responded to treatment with sodium-glucose cotransporter 2 inhibitors (SGLT2i). Patients with type 2 diabetes mellitus and non-hypertrophic cardiomyopathy (nHCM) with New York Heart Association class II-III symptoms participated in a prospective open-label study from January 2019 to October 2020. A lower-than-50% LV ejection fraction threshold was used to exclude patients. In the SGLT2i arm, patients were enrolled between January and November 2019, while in the control arm, patients were enrolled between November of 2019 and October of 2020. For this study, success was defined as a decrease of at least one functional class on the ≥1 New York Heart Association scale and an increase of at least 1.5 in E/e′ after 6 months of treatment.
There were no significant differences between the baseline SGLT2i (n=24) and control (n=24) groups at baseline. Patients in the SGLT2i group were much more likely to reach the primary end point (70.8% vs. 4.2%, P<0.001) than those in the control group. All measures of diastolic function improved significantly in the SGLT2i group after 6 months of treatment (E/e′ 16.3 ±1.9 vs. 13.3± 1.6, P<0.001; E/A 2.8 ±0.1 vs. 2.4± 0.1, P<0.001; left atrial volume 45.6 5.2 vs. 40.8 4.9 ml/m2 vs. 40.8 Patients who were given SGLT2i also had increases in N-terminal pro-B-type natriuretic peptide (481.4 ±52.6 vs 440.9 ±43.9 pg/ml, P<0.001) and 6-minute walk distance (295.1 ±31.5 vs 343.0 ±31.1 m, P<0.001).
After 6 months of treatment, there was no statistically significant difference in LV mass between the SGLT2i and control groups (0.1± 0.3 vs 0.1± 0.5 g/m2, P=0.319). Due to a urinary tract infection, a patient in the SGLT2i group stopped taking their medication. Diastolic function and functional capacity were both enhanced by SGLT2i usage in patients with diabetes who had nHCM and retained LV function.
Source: sciencedirect.com/science/article/abs/pii/S000291492201178X
