Regression of left ventricular hypertrophy with SGLT2 inhibitors
Abstract
Listen to the podcast associated with this article, which can also befound at ESC CardioTalk https://www.escardio.org/The-ESC/Whatwe-do/news/ESC-Cardio-Talk This editorial refers to ‘A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type 2 diabetes: the DAPA-LVH trial’†, by A.J.M. Brown et al., on page 3421. Patients with type 2 diabetes (T2D) are at risk for both heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF), and, until recently, no breakthrough therapies were shown to be really effective in this patient population.1 , 2 The advent of sodium–glucose co-transporter-2 (SGLT2) inhibitors has profoundly changed the natural history of diabetic cardiovascular (CV) complications and, more specifically, diabetic HF.3 Four randomized clinical trials, namely the EMPA-REG OUTCOME (empagliflozin), CANVAS (canagliflozin), DECLARE‐TIMI 58, and DAPA-HF (both with dapagliflozin), have unanimously showed a striking effect of SGLT2 inhibitors in reducing HF hospitalizations in T2D patients with established atherosclerotic CV disease (CVD).4 A recent meta-analysis showed that SGLT2 inhibitors reduced the risk of CV death or HF hospitalization by 23% [hazard ratio 0.77, 95% confidence interval (CI) 0.71–0.84, P < 0.0001], with a similar benefit in patients with and without atherosclerotic CVD or HF.5 Since the publication of these trials, many experimental and pre-clinical studies appeared in rapid succession to uncover…
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