Impact of SGLT2 inhibitor on clinical and echocardiographic outcomes in patients with CRT during long-term period.

IF 2.6 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Tariel A Atabekov, Sergey N Krivolapov, Irina K Silivanova, Mikhail S Khlynin, Irina V Kisteneva, Roman E Batalov, Sergey V Popov
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引用次数: 0

Abstract

Background: The sodium-glucose co-transporter 2 inhibitors (SGLT2i) have improved the outcomes of patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). However, their effects in cardiac resynchronization therapy (CRT) recipients are relatively scarce. This study has investigated the impact of SGLT2i treatment on clinical and echocardiographic outcomes in CRT patients at long-term follow-up.

Methods: Patients with HF, New York Heart Association (NYHA) II-III class, and LVEF ≤ 35% referred for CRT implant were enrolled. Patients were grouped in non-SGLT2i (1st group) and SGLT2i treatment (2nd group) cohorts. Clinical and echocardiographic outcomes were evaluated at 24 months. Patients were classified as CRT responders if they remained alive without HF hospitalization, experienced an improvement of at least one NYHA class, and had left ventricular end-systolic volume reduction ≥ 15%.

Results: A total of 82 patients were enrolled. At 24-month follow-up, 22 of 41 (53.6%) patients in the 1st group and 32 of 41 (78.0%) in the 2nd group were classified as CRT responders (p = 0.019). In multivariable analysis, the left bundle branch block eligible to Strauss criteria (LBBBS) (odds ratio (OR) 9.58; confidence interval (CI) 95% 1.71-53.53; p = 0.01) and SGLT2i treatment (OR 3.32; CI 95% 1.18-9.30; p = 0.022) were independent predictors of CRT response.

Conclusion: The SGLT2i treatment in CRT patients improves the combined CRT response at long-term follow-up. In our patient cohort, the CRT response is associated with LBBBS morphology and SGLT2i treatment.

SGLT2抑制剂对CRT患者长期临床及超声心动图结果的影响。
背景:钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)改善了心力衰竭(HF)和左心室射血分数(LVEF)降低患者的预后。然而,它们在心脏再同步化治疗(CRT)接受者中的作用相对较少。本研究探讨了SGLT2i治疗对CRT患者长期随访的临床和超声心动图结果的影响。方法:纳入HF,纽约心脏协会(NYHA) II-III级,LVEF≤35%转介CRT植入的患者。患者分为非SGLT2i组(第一组)和SGLT2i治疗组(第二组)。24个月时评估临床和超声心动图结果。如果患者在没有HF住院的情况下仍然存活,经历至少一个NYHA级别的改善,并且左心室收缩末期容积减少≥15%,则将其归类为CRT应答者。结果:共纳入82例患者。随访24个月,第一组41例患者中有22例(53.6%),第二组41例患者中有32例(78.0%)达到CRT应答(p = 0.019)。在多变量分析中,左束支阻滞符合Strauss标准(LBBBS)(优势比(OR) 9.58;置信区间(CI) 95% 1.71 ~ 53.53;p = 0.01)和SGLT2i治疗(OR 3.32;Ci 95% 1.18-9.30;p = 0.022)是CRT疗效的独立预测因子。结论:经长期随访,SGLT2i治疗可提高CRT患者的综合疗效。在我们的患者队列中,CRT反应与LBBBS形态和SGLT2i治疗有关。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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