Impact of SGLT2 inhibitors on functional outcomes in heart failure patients according to the aetiology.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2025-07-20 DOI:10.1080/14779072.2025.2534712

Emanuele Coppo, Alberto Giráldez Valpuesta, Juan José Serrano Silva, Jaime Fernández Rebollo, Eva González Caballero, Sergio Gamaza Chulián

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引用次数: 0

Abstract

Background: Exercise intolerance is a significant symptom of heart failure with reduced ejection fraction (HFrEF) and is associated with poor outcomes. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits, their impact on functional capacity remains debated. This study aimed to assess the effects of SGLT2i on exercise capacity and quality of life in patients with ischemic and non-ischemic HFrEF.

Research design and methods: Patients with a recent diagnosis of HFrEF and stable clinical status, referred to a heart failure unit, were prospectively enrolled. Exercise capacity was evaluated using the six-minute walk test (6MWT), and quality of life with the Minnesota Living with Heart Failure Questionnaire (MLHFQ) both at baseline and after 6 months. Patients were stratified by etiology and analyzed according to SGLT2i use.

Results: A total of 462 patients were included (275 non-ischemic, 187 ischemic); 86 (18.6%) received SGLT2i (45 non-ischemic, 41 ischemic). At 6 months, SGLT2i treatment significantly improved 6MWT in non-ischemic patients (+31.9 m, p = 0.005), but not in ischemic patients (+9.0 m, p = 0.411; P-interaction = 0.034). MLHFQ scores improved similarly in both groups, with no significant differences related to SGLT2i use.

Conclusions: SGLT2i improved exercise capacity only in non-ischemic HFrEF patients, suggesting a differential response based on etiology.

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根据病因，SGLT2抑制剂对心力衰竭患者功能结局的影响

背景：运动不耐受是心力衰竭伴射血分数降低（HFrEF）的重要症状，并与不良预后相关。虽然钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）已被证明对心血管有益，但其对功能容量的影响仍存在争议。本研究旨在评估SGLT2i对缺血性和非缺血性HFrEF患者运动能力和生活质量的影响。研究设计和方法：前瞻性纳入近期诊断为HFrEF且临床状态稳定的心衰单位患者。使用6分钟步行测试（6MWT）评估运动能力，并在基线和6个月后使用明尼苏达心力衰竭生活问卷（MLHFQ）评估生活质量。根据病因对患者进行分层，并根据SGLT2i的使用情况进行分析。结果：共纳入462例患者（非缺血性275例，缺血性187例）；86例（18.6%）接受SGLT2i治疗（非缺血性45例，缺血性41例）。6个月时，SGLT2i治疗可显著改善非缺血性患者的6MWT (+31.9 m, p = 0.005)，但缺血性患者无显著改善(+9.0 m, p = 0.411；p -相互作用= 0.034)。两组的MLHFQ评分均有相似的改善，与SGLT2i的使用没有显著差异。结论：SGLT2i仅改善非缺血性HFrEF患者的运动能力，提示基于病因的差异反应。

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

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.