Efficacy of SGLT2 Inhibitors in Patients With Diabetes and Nonobstructive Hypertrophic Cardiomyopathy
Graphical Abstract
SGLT2i therapy in patients with diabetes with nonobstructive hypertrophic cardiomyopathy with a preserved left ventricular function: an open-label study.
In this open-label study, the administration of sodium glucose co-transporter 2 inhibitors, on top of optimal medical treatment, to patients with diabetes with nonobstructive hypertrophic cardiomyopathy improved diastolic function, N-terminal pro-B-type natriuretic peptide, ameliorated New York Heart Association functional class, and enhanced exercise capacity.
Section snippets
Methods
A prospective, open-label, blinded end point trial was performed to determine whether SGLT2is could improve diastolic function and functional capacity in patients with nHCM. Consecutive patients were screened and recruited from the Institutional Hypertrophic Cardiomyopathy Clinic between January 2019 and October 2020. The trial was approved by the institutional ethics committee, and the participants provided written informed consent before enrollment. The study was conducted according the
Results
From January 2019 and October 2020, 52 patients with an HCM phenotype were initially screened. Figure 1 summarizes participant flow during the study. A patient discontinued SGLT2 treatment during the study because of drug-related adverse effects but completed the study visits through 6 months. Of the screened patients, 1 did not satisfy the inclusion criteria and the other refused to participate.
Patient demographics and baseline clinical variables are shown in Table 1. Of the 48 recruited
Discussion
This study evaluated the effects of SGLT2i in patients with diabetes mellitus and nHCM. The main findings of this study were: (1) the addition of SGLT2i to standard HF therapy improved diastolic function and NYHA functional class, (2) there was concomitant improvement in 6-minute walk distance and NT-proBNP levels, and (3) treatment with SGLT2i was safe and well tolerated in most patients. To the best of our knowledge, this is the first report evaluating the efficacy of SGLT2i in patients with
Disclosures
The authors have no conflicts of interest to declare.
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Drs. Sravani, Krishna, and Bijjam contributed equally to this work.
Funding: None.