Experience with sodium glucose cotransporter-2 inhibitors in adult patients with Fontan circulation.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Clinical and Experimental Medicine Pub Date : 2025-01-14 DOI:10.17219/acem/194617

Paweł Skorek, Magdalena M Frączek-Jucha, Agnieszka Sarnecka, Maciej Skubera, Natasza Libiszewska, Lidia Tomkiewicz-Pająk

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引用次数: 0

Abstract

Background: We still know little about the effective pharmacological treatment of heart failure (HF) associated with the Fontan circulation. One of the new options may be sodium glucose cotransporter-2 inhibitors (SGLT2i), which have been proven effective in classic forms of left ventricular HF.

Objectives: To evaluate the effect and safety of SGLT2i inclusion in adults with Fontan circulation. To this end, we conducted observation and complex diagnostics of adult Fontan patients in whom we started treatment with flozins.

Material and methods: The study population consisted of 17 adult Fontan patients with average age 30.5 (9.7) years, 59% in II New York Heart Association (NYHA) class, among whom 53% received dapagliflozin and rest empagliflozin.

Results: The average observation time was 11.0 (3.7) months. None of the patients have reported side effects or complications related to treatment. We observed a significant increase (20.1 mL/kg/min vs 24.2 mL/kg/min, p = 0.008) in the median of maximum oxygen uptake (VO2 max) among participants (9) who completed at least 2 reliable cardiopulmonary exercise tests. We did not notice any significant differences in N-terminal prohormone of brain natriuretic peptide concentration (641.35 (923.7) vs 741.47 (1,139.02), p = 0.12) after the inclusion. Interestingly, we observed a significant increase in erythrocytes (+6%, p = 0.003), hemoglobin (+7%, p = 0.03) and hematocrit (+7%, p = 0.02).

Conclusions: To the best of our knowledge, this is the first study to demonstrate that the implementation of SGLT2i may have a positive effect on exercise capacity among adults with Fontan circulation. Our experience confirms the high safety of using these drugs in Fontan adults.

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葡萄糖共转运蛋白-2抑制剂钠治疗成人方丹循环的经验。

背景：对于与方丹循环相关的心力衰竭（HF）的有效药物治疗，我们仍然知之甚少。其中一个新的选择可能是葡萄糖共转运蛋白-2抑制剂钠（SGLT2i），它已被证明对经典形式的左室HF有效。目的：评价SGLT2i纳入方坦循环成人患者的疗效和安全性。为此，我们对成年Fontan患者进行了观察和复杂诊断，我们开始用flozins治疗。材料和方法：研究人群包括17例成年Fontan患者，平均年龄30.5（9.7）岁，59%为纽约心脏协会（NYHA） II级，其中53%接受达格列净治疗，其余恩格列净治疗。结果：平均观察时间11.0（3.7）个月。没有患者报告与治疗相关的副作用或并发症。我们观察到，在完成至少2次可靠的心肺运动试验的参与者中，最大摄氧量（VO2 max）的中位数显著增加（20.1 mL/kg/min vs 24.2 mL/kg/min, p = 0.008）。纳入后，我们未发现脑利钠肽n端激素原浓度有显著差异(641.35 （923.7)vs 741.47 (1139.02), p = 0.12）。有趣的是，我们观察到红细胞（+6%,p = 0.003）、血红蛋白（+7%,p = 0.03）和红细胞压积（+7%,p = 0.02）显著增加。结论：据我们所知，这是第一个证明SGLT2i的实施可能对Fontan循环成人运动能力有积极影响的研究。我们的经验证实，在方丹成人中使用这些药物的安全性很高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.