Body fluid regulation via chronic inhibition of sodium–glucose cotransporter-2 in patients with heart failure: a post hoc analysis of the CANDLE trial

Background In patients with chronic heart failure (CHF) and type 2 diabetes (T2D), sodium–glucose cotransporter-2 (SGLT2) inhibition improves cardiorenal outcomes, but details of the effects on distinct subsets of body fluid volume remain incomplete. Methods This was a post hoc analysis of patients...

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Published in:Clinical research in cardiology 2023, Vol.112 (1), p.87-97
Main Authors: Fujiki, Shinya, Tanaka, Atsushi, Imai, Takumi, Shimabukuro, Michio, Uehara, Hiroki, Nakamura, Ikuko, Matsunaga, Kazuo, Suzuki, Makoto, Kashimura, Takeshi, Minamino, Tohru, Inomata, Takayuki, Node, Koichi
Format: Article
Language:English
Subjects:
Body Fluids
Brain natriuretic peptide
Canagliflozin - therapeutic use
Cardiology
Chronic Disease
Congestive heart failure
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Failure analysis
Glucose
Glucosides - pharmacology
Heart failure
Heart Failure - drug therapy
Humans
Medicine
Medicine & Public Health
Na+/glucose cotransporter
Original Paper
Sodium
Sodium-Glucose Transporter 2
Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
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Summary:Background In patients with chronic heart failure (CHF) and type 2 diabetes (T2D), sodium–glucose cotransporter-2 (SGLT2) inhibition improves cardiorenal outcomes, but details of the effects on distinct subsets of body fluid volume remain incomplete. Methods This was a post hoc analysis of patients with CHF and T2D in the CANDLE trial (UMIN000017669), an investigator-initiated, multi-center, randomized open-label trial that compared the effect of canagliflozin (100 mg, n  = 113) with glimepiride (starting dose: 0.5 mg, n  = 120) on changes in N-terminal pro-brain natriuretic peptide. The estimated plasma volume (ePV, calculated with the Straus formula) and estimated extracellular volume (eEV, determined by the body surface area) were compared between treatment groups at weeks 4, 12, and 24. Results Among 233 patients analyzed, 166 (71.2%) had an ejection fraction (EF) > 50%. Reductions in ePV and eEV were observed only in the canagliflozin group until week 12 (change from baseline at week 12, ePV; − 7.63%; 95% confidence interval [CI], − 10.71 to − 4.55%, p  
ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-022-02049-4