당뇨병을 동반하지 않는 심부전 환자에서 SGLT2 Inhibitor의 심장기능에 대한 효과|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Background : Extensive clinical studies have demonstrated that irrespective of diabetes status, sodium glucose co-transporter 2 inhibitors (SGLT2i) effectively reduce heart failure-related hospitalizations, and are advantageous in enhancing cardiac function. However, limited domestic studies have focused on the effects of SGLT2i in non-diabetic heart failure (HF) patients. Therefore, this study aims to investigate the cardiac function effects of SGLT2i in Korean HF patients without diabetes.
Methods : This retrospective study analyzed electronic medical records from January 2021 to December 2022. We focused on adult HF patients without diabetes who started SGLT2i therapy at Tertiary Hospital. The evaluation of cardiac function improvement involved comparing echocardiographic parameters before the initiation of SGLT2i therapy, and at intervals ranging (3 to 12) months post-therapy.
Results : This study comprised 128 patients, divided into two groups based on left ventricular ejection fraction (LVEF) and SGLT2i type. The median duration of follow-up was 189 days. Following treatment with SGLT2i, significant reductions were observed in left ventricular end-diastolic dimension (−2.7 mm; p<0.01), left ventricular end-systolic dimension (−3.3 mm; p<0.01), left ventricular mass index (−11.5 g/m2; p<0.01), and left atrium volume index (−4.5 mL/m2; p<0.01). Furthermore, significant improvement in LVEF was observed, showing an increase of 3.9% (p<0.01). The enhancement of cardiac function following SGLT2 inhibitor treatment was notably more significant in patients with LVEF ≤ 40%.
Conclusion : The findings of this study demonstrate that in Korean non-diabetic HF patients, SGLT2i led to significant improvements in cardiac function, as evidenced by echocardiographic parameter alterations. Notably, these improvements were more pronounced in patients with reduced ejection fraction. Additionally, the study found no significant difference in cardiac function outcomes between empagliflozin and dapagliflozin treatments. This suggests that SGLT2i may offer a viable therapeutic option for managing HF with reduced ejection fraction in non-diabetic patients.

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참고문헌 (Reference)

1 Murphy WG, "The sex difference in haemoglobin levels in adults-mechanisms, causes, and consequences" 28 (28): 41-47, 2014

2 Lam CSP, "Sex differences in heart failure" 40 (40): 3859-3868, 2019

3 Santos-Gallego CG, "Randomized Trial of Empagliflozin in Nondiabetic Patients With Heart Failure and Reduced Ejection Fraction" 77 (77): 243-255, 2021

4 Januzzi JL Jr, "Prognostic Importance of NT-proBNP and Effect of Empagliflozin in the EMPEROR-Reduced Trial" 78 (78): 1321-1332, 2021

5 최진오 ; 신미승 ; 김미정 ; 정해억 ; 박정랑 ; 손일석 ; 김형섭 ; 박성미 ; 유남진 ; 최정현 ; 김형관 ; 조구영 ; 이미래 ; 박진선 ; 심지영 ; 김대희 ; 신대희 ; 신길자 ; 신성희 ; 김계훈 ; 박재형 ; 이상엽 ; 김우식 ; 박승우, "Normal Echocardiographic Measurements in a Korean Population Study : Part I. Cardiac Chamber and Great Artery Evaluation" 23 (23): 158-172, 2015

6 Lopaschuk GD, "Mechanisms of Cardiovascular Benefits of Sodium Glucose Co-Transporter 2(SGLT2)Inhibitors : A State-of-the-Art Review" 5 (5): 632-644, 2020

7 Fabijanovic D, "Left Ventricular Size and Ejection Fraction : Are They Still Relevant?" 15 (15): 147-158, 2019

8 The Korean Society of Heart Failure, "Korea heart failure fact sheet 2022"

9 Ministry of Food and Drug Safety, "Jardian 10 mg (empagliflozin)"

10 Pascual-Figal DA, "Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure : The DAPA-MODA study" 25 (25): 1352-1360, 2023