Potential Hematopoietic Effects of SGLT2 Inhibitors in Patients with Cardiac Amyloidosis.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2025-03-20 eCollection Date: 2025-03-01 DOI:10.31083/RCM26081

Nikita Ermolaev, Robin Willixhofer, Christoph Krall, Christina Kronberger, René Rettl, Christina Binder, Franz Duca, Christian Nitsche, Andreas Kammerlander, Michael Poledniczek, Bernhard Gregshammer, Diana Ahmadi-Fazel, Mahshid Eslami, Luciana Camuz Ligios, Johannes Kastner, Jutta Bergler-Klein, Roza Badr Eslam

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引用次数: 0

Abstract

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been found to have potential hematopoietic effects in patients with heart failure (HF). However, these benefits have not been studied in patients with cardiac amyloidosis (CA). CA patients present with HF symptoms and often suffer from iron deficiency, which has a negative impact on erythropoiesis and leads to lower hemoglobin and hematocrit levels. We sought to determine the potential effects of SGLT2i on hematological parameters and functional capacity (FC) in CA patients.

Methods: A prospective analysis was conducted to compare the effects of SGLT2i in patients who received the best medical therapy (BMT) along with SGLT2i (n = 20), versus patients receiving only BMT without SGLT2i (n = 20) (historical control group). All patients underwent blood testing and cardiopulmonary exercise testing (CPET) at baseline (BL) and after 6 months [interquartile range (IQR): 4.0 to 8.0].

Results: The SGLT2i-based therapy resulted in a significant improvement and difference in hematological parameters at 6 months follow-up compared to the control group. In the SGLT2i group, the mean hemoglobin level increased (+1.2 mg/dL), whereas in the control group, it decreased (-0.8 g/dL) (p < 0.001 for overall group comparison). The hematocrit showed a significant increase in the SGLT2i group (+4.4%) compared to a decrease in the control group (-1.8%) (p < 0.001). Additionally, the serum iron level improved in the SGLT2i-treated group (+ 5.5 [-5.0 to 17.5] μg/dL vs. -6.0 [-15.0 to 4.0] μg/dL, p = 0.121). Although there was no significant change in the peak oxygen consumption (peak VO₂, (mL/min)/kg) (p = 0.206), as well as in pulmonary ventilation (VE)/carbon dioxide production (VCO₂) slope in both groups (p = 0.964), the SGLT2i group maintained a peak VO₂ and VE/VCO₂ slope throughout the study.

Conclusions: SGLT2i therapy improved hematological parameters and stabilized the FC of CA patients.

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SGLT2抑制剂对心脏淀粉样变性患者的潜在造血作用。

背景：钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）已被发现对心力衰竭（HF）患者具有潜在的造血作用。然而，这些益处尚未在心脏淀粉样变性（CA）患者中进行研究。CA患者表现为心衰症状，常伴有缺铁，这对红细胞生成有负面影响，导致血红蛋白和红细胞压积水平降低。我们试图确定SGLT2i对CA患者血液学参数和功能容量（FC）的潜在影响。方法：前瞻性分析比较SGLT2i在接受最佳药物治疗（BMT）同时接受SGLT2i的患者（n = 20）与仅接受BMT而不接受SGLT2i的患者（n = 20）（历史对照组）中的效果。所有患者在基线（BL）和6个月后进行血液检查和心肺运动试验（CPET）[四分位数范围（IQR）： 4.0至8.0]。结果：与对照组相比，以sgltti为基础的治疗在随访6个月时血液学参数有显著改善和差异。在SGLT2i组中，平均血红蛋白水平升高（+1.2 mg/dL），而在对照组中，平均血红蛋白水平下降（-0.8 g/dL）（总组比较p < 0.001）。与对照组（-1.8%）相比，SGLT2i组的红细胞压积显著增加（+4.4%）（p < 0.001）。此外，sgltti治疗组血清铁水平提高（+ 5.5 [-5.0 ~ 17.5]μg/dL vs. -6.0 [-15.0 ~ 4.0] μg/dL, p = 0.121）。虽然两组的峰值耗氧量（峰值VO2， (mL/min)/kg）（p = 0.206）以及肺通气(VE)/二氧化碳生成（VCO2）斜率（p = 0.964）没有显著变化，但SGLT2i组在整个研究过程中保持了峰值VO2和VE/VCO2斜率。结论：SGLT2i治疗改善了CA患者的血液学参数，稳定了FC。

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

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.