SGLT2 inhibitors and cardiac remodelling: a systematic review and meta‐analysis of randomized cardiac magnetic resonance imaging trials

Aims Recent large randomized controlled trials (RCTs) have demonstrated efficacy of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) in both preventing and treating heart failure (HF). SGLT2i‐induced reversal of left ventricular remodelling has been proposed as a mechanism contributing to this eff...

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Bibliographic Details
Published in:ESC Heart Failure 2021-12, Vol.8 (6), p.4693-4700
Main Authors: Dhingra, Nitish K., Mistry, Nikhil, Puar, Pankaj, Verma, Raj, Anker, Stefan, Mazer, C. David, Verma, Subodh
Format: Article
Language:English
Subjects:
Bias
Cardiac magnetic resonance imaging
Cardiac remodelling
Diabetes
Ejection fraction
Heart failure
HFrEF
Intervention
Magnetic resonance imaging
Meta-analysis
Patients
SGLT2i
Short Communication
Short Communications
Systematic review
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Summary:Aims Recent large randomized controlled trials (RCTs) have demonstrated efficacy of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) in both preventing and treating heart failure (HF). SGLT2i‐induced reversal of left ventricular remodelling has been proposed as a mechanism contributing to this effect. Methods and results We performed a systematic review and meta‐analysis of RCTs to compare SGLT2i versus placebo (treatment duration >3 months) on cardiac remodelling parameters as measured by cardiac magnetic resonance imaging (cMRI) in patients with HF and/or diabetes. The PubMed and ClinicalTrials.gov databases were searched until 15 June 2021. Our primary outcome was change in absolute left ventricular mass (LVM) from baseline to study endpoint. Secondary outcomes included changes in LVM indexed to body surface area, left ventricular end‐systolic volume (LVESV), left ventricular end‐diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) from baseline to study endpoint. The Cochrane Collaboration's tool was used to assess risk of bias. Five studies representing 408 patients were included. SGLT2i was associated with greater LVM regression compared to placebo (MD, −5.76 g; 95% CI, −10.87 g to −0.64 g, I2 = 73%; overall effect, P 
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.13645