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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Association between chronic sodium-glucose cotransporter 2 inhibitors use and right ventricular function in hemodynamically stable patients with acute pulmonary embolism

  • Gassan Moady1,2
  • Shir Maman2
  • Robert Dragu2
  • Lihi Levi-Gofman2
  • Shaul Atar1,2
  1. 1Department of Cardiology, Galilee Medical Center
  2. 2Azrieli Faculty of Medicine, Bar Ilan University
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Abstract

Background: Acute pulmonary embolism (PE) is a common cardiovascular disorder associated with substantial morbidity and mortality, with prognosis largely determined by the extent of right ventricular (RV) involvement. Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve outcomes in patients with heart failure (HF) and exert favorable effects on left ventricular (LV) remodeling; however, their effects on RV function in acute PE remain largely unexplored. We hypothesized that chronic treatment with SGLT2 inhibitors would be associated with a lower incidence of clinical congestion and a more favorable clinical course in patients with acute PE.

Methods: We retrospectively compared 30 patients receiving chronic SGLT2 inhibitor therapy with 90 controls following 1:3 matching for multiple variables, including age, sex, comorbidities, and background medical therapy. Echocardiographic and clinical outcomes were compared between the groups, including tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (SPAP), and clinical congestion.

Results: Patients receiving SGLT2 inhibitors had higher TAPSE values (19.4 ± 2.7 vs. 17.3 ± 5, 95% Confidence interval (CI) 0.7–3.5, p = 0.004), fewer signs of clinical congestion [6.7% vs. 25.6%, Odds ratio (OR) 0.21, 95% CI 0.05–0.94, p = 0.03], lower troponin, [14.5 (5.3–51), vs. 64.5 (20–177), 95% CI (33–108), p < 0.001], and lower N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, [158 (96–443) vs. 1000 (333–3433), 95% CI (467–1153) pg/mL, p < 0.001]. No significant between-group difference was observed in 1-year readmissions due to dyspnea or clinical congestion [OR 0.34, 95% CI (0.1–1.2), p = 0.13].

Conclusions: Among hemodynamically stable patients with acute PE, chronic SGLT2 inhibitor therapy was associated with more favorable RV function during the index event; however, this association did not translate into improved long-term clinical outcomes. These findings warrant confirmation in prospective studies.

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Cite

BibTeXRIS
BibTeX
@article{moady2026association,
  title = {{Association between chronic sodium-glucose cotransporter 2 inhibitors use and right ventricular function in hemodynamically stable patients with acute pulmonary embolism}},
  author = {Gassan Moady and Shir Maman and Robert Dragu and Lihi Levi-Gofman and Shaul Atar},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1975531},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1975531/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association between chronic sodium-glucose cotransporter 2 inhibitors use and right ventricular function in hemodynamically stable patients with acute pulmonary embolism
AU  - Gassan Moady
AU  - Shir Maman
AU  - Robert Dragu
AU  - Lihi Levi-Gofman
AU  - Shaul Atar
PY  - 2026
DA  - 2026/10/26
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1975531
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1975531/full
AB  - Background: Acute pulmonary embolism (PE) is a common cardiovascular disorder associated with substantial morbidity and mortality, with prognosis largely determined by the extent of right ventricular (RV) involvement. Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve outcomes in patients with heart failure (HF) and exert favorable effects on left ventricular (LV) remodeling; however, their effects on RV function in acute PE remain largely unexplored. We hypothesized that chronic treatment with SGLT2 inhibitors would be associated with a lower incidence of clinical congestion and a more favorable clinical course in patients with acute PE.  Methods: We retrospectively compared 30 patients receiving chronic SGLT2 inhibitor therapy with 90 controls following 1:3 matching for multiple variables, including age, sex, comorbidities, and background medical therapy. Echocardiographic and clinical outcomes were compared between the groups, including tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (SPAP), and clinical congestion.  Results: Patients receiving SGLT2 inhibitors had higher TAPSE values (19.4 ± 2.7 vs. 17.3 ± 5, 95% Confidence interval (CI) 0.7–3.5, p = 0.004), fewer signs of clinical congestion [6.7% vs. 25.6%, Odds ratio (OR) 0.21, 95% CI 0.05–0.94, p = 0.03], lower troponin, [14.5 (5.3–51), vs. 64.5 (20–177), 95% CI (33–108), p < 0.001], and lower N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, [158 (96–443) vs. 1000 (333–3433), 95% CI (467–1153) pg/mL, p < 0.001]. No significant between-group difference was observed in 1-year readmissions due to dyspnea or clinical congestion [OR 0.34, 95% CI (0.1–1.2), p = 0.13].  Conclusions: Among hemodynamically stable patients with acute PE, chronic SGLT2 inhibitor therapy was associated with more favorable RV function during the index event; however, this association did not translate into improved long-term clinical outcomes. These findings warrant confirmation in prospective studies.
SN  - 2297-055X
ER  -