Changes in Left Ventricular Volumes and Function After Initiation of Sodium–Glucose Cotransporter-2 Inhibitors in Patients with Heart Failure and Predominantly Reduced Ejection Fraction: A Real-World Echocardiographic Study
4 affiliations
- 1Cardiology Unit, Emergency and Urgency Department, Policlinico Riuniti University Hospital, 71100 Foggia, Italy
- 2Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, 98125 Messina, Italy
- 3Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
- 4Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
Abstract
Background: Sodium–glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes in heart failure (HF), but baseline characteristics associated with left ventricular (LV) changes after their initiation in routine practice are incompletely defined. Methods: In this retrospective two-centre study, 101 patients with HF (94 HFrEF, 6 HFmrEF, 1 HFpEF) initiating an SGLT2i underwent echocardiography at baseline and 6 months. For the purposes of this study, LV reverse remodelling was defined as a simultaneous reduction in LV end-diastolic (LVEDV) and end-systolic volume (LVESV); LVESV reductions ≥10% and ≥15% were used as stringent definitions. Associations were explored with Firth logistic regression adjusted for age and baseline LVEF. Death or HF hospitalisation after the 6-month visit was analysed in relation to 6-month changes (landmark analysis). Results: Median LVEF increased from 28.8% at baseline to 31.6% at 6 months, and the medians of individual paired changes in LVEDV and LVESV were −13.0% and −16.3% (all p < 0.001). The operational definition was met by 74 patients (73.3%) and an LVESV reduction ≥15% by 56 (55.4%). Higher BMI and larger baseline LVEDV were associated with LV volume reduction, and lower TAPSE with LVEF response, LVESV reduction ≥15% and NYHA improvement. No statistically significant association was observed between 6-month changes in LVEF or LV volumes and subsequent death or HF hospitalisation; confidence intervals were wide. Conclusions: In this uncontrolled cohort, SGLT2i initiation was followed by modest LV volume reduction and a small LVEF increase. These associations are exploratory and hypothesis-generating.
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BibTeX
@article{tricarico2026changes,
title = {{Changes in Left Ventricular Volumes and Function After Initiation of Sodium–Glucose Cotransporter-2 Inhibitors in Patients with Heart Failure and Predominantly Reduced Ejection Fraction: A Real-World Echocardiographic Study}},
author = {Lucia Tricarico and Michele Granatiero and Roberto Licordari and Elena Costabile and Ginevra Perconti and Savino Cafagna and Florinda Rosa Bonanno and Luca Battisti and Francesca Delia and Massimo Iacoviello and Natale Daniele Brunetti and Giuseppe Dattilo and Michele Correale},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218679},
url = {https://www.mdpi.com/2077-0383/15/21/8679},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Changes in Left Ventricular Volumes and Function After Initiation of Sodium–Glucose Cotransporter-2 Inhibitors in Patients with Heart Failure and Predominantly Reduced Ejection Fraction: A Real-World Echocardiographic Study
AU - Lucia Tricarico
AU - Michele Granatiero
AU - Roberto Licordari
AU - Elena Costabile
AU - Ginevra Perconti
AU - Savino Cafagna
AU - Florinda Rosa Bonanno
AU - Luca Battisti
AU - Francesca Delia
AU - Massimo Iacoviello
AU - Natale Daniele Brunetti
AU - Giuseppe Dattilo
AU - Michele Correale
PY - 2026
DA - 2026/11/06
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218679
UR - https://www.mdpi.com/2077-0383/15/21/8679
AB - Background: Sodium–glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes in heart failure (HF), but baseline characteristics associated with left ventricular (LV) changes after their initiation in routine practice are incompletely defined. Methods: In this retrospective two-centre study, 101 patients with HF (94 HFrEF, 6 HFmrEF, 1 HFpEF) initiating an SGLT2i underwent echocardiography at baseline and 6 months. For the purposes of this study, LV reverse remodelling was defined as a simultaneous reduction in LV end-diastolic (LVEDV) and end-systolic volume (LVESV); LVESV reductions ≥10% and ≥15% were used as stringent definitions. Associations were explored with Firth logistic regression adjusted for age and baseline LVEF. Death or HF hospitalisation after the 6-month visit was analysed in relation to 6-month changes (landmark analysis). Results: Median LVEF increased from 28.8% at baseline to 31.6% at 6 months, and the medians of individual paired changes in LVEDV and LVESV were −13.0% and −16.3% (all p < 0.001). The operational definition was met by 74 patients (73.3%) and an LVESV reduction ≥15% by 56 (55.4%). Higher BMI and larger baseline LVEDV were associated with LV volume reduction, and lower TAPSE with LVEF response, LVESV reduction ≥15% and NYHA improvement. No statistically significant association was observed between 6-month changes in LVEF or LV volumes and subsequent death or HF hospitalisation; confidence intervals were wide. Conclusions: In this uncontrolled cohort, SGLT2i initiation was followed by modest LV volume reduction and a small LVEF increase. These associations are exploratory and hypothesis-generating.
SN - 2077-0383
ER -