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Effect of Sodium-Glucose Co-transporter-2 Inhibitors on Ventricular Repolarization Markers in Heart Failure with Reduced Ejection Fraction

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Abstract

Background and Aim

Sodium-glucose co-transporter-2 (SGLT2) inhibitors added to optimal medical therapy have been shown to reduce the risk of cardiovascular death and recurrent heart failure (HF) hospitalization in HF patients. We aimed to evaluate the effect of SGLT2 inhibitors on the ventricular repolarization markers (VRM) in patients with HF with reduced ejection fraction (HFrEF).

Methods

51 patients with HFrEF who had symptoms New York Heart Association (NYHA) class II–IV despite optimal medical treatment and were added SGLT2 inhibitors to their treatment were included in the study. Electrocardiography (ECG) and laboratory results obtained before the treatment and at the first-month follow-up visit were compared. QT, QTc (corrected by Bazett formula), QT dispersion (QTd), QTc dispersion (QTc-d), Tpeak to Tend (Tp-e) interval, Tp-e/QT, and Tp-e/QTc ratios were measured and defined as VRM.

Results

A significant decrease was observed in HR, QT, QTc intervals, and QTd compared to pre-treatment. While the mean Tp-e interval was 101.5 ± 11.7 ms before treatment, it decreased to 93.1 ± 12.7 ms after treatment (p < 0.001). There was a significant decrease in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels after treatment [2859 ± 681vs.1266 ± 763, respectively (p < 0.001)] and QTd, Tp-e interval, and Tp-e/QTc ratio was positively correlated with the change in NT-proBNP level.

Conclusions

The addition of SGLT2 inhibitors to optimal medical therapy in HFrEF patients positively changes VRM (QT, QTc, QTd, Tp-e, and Tp-e/QTc).

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Data Availability

The data that support the findings of this study are available on request from the corresponding author.

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Authors and Affiliations

  1. Department of Cardiology, Giresun University Medical Faculty, Giresun, Turkey

    Emre Yılmaz, Ertan Aydın, Sencer Çamcı & Devrim Kurt

  2. Department of Cardiology, Kanuni Training and Research Hospital, Trabzon, Turkey

    Ercan Aydın

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  1. Emre Yılmaz
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Contributions

Author E. Y. has given substantial contributions to the conception or the design of the manuscript. Authors E. Y., E. A., and S. Ç. made the acquisition, analysis, and interpretation of the data. All authors have participated in drafting the manuscript. Authors D. K. and E. A. revised it critically. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Ercan Aydın.

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Ethics Statement

Approval for the study was granted by the Ethics Committee of Ordu Faculty of Medicine Ethics Committee, date: 28.01.2022, issue number: 2022/17). All procedures were made in compliance with the principles of the Helsinki Declaration.

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Yılmaz, E., Aydın, E., Çamcı, S. et al. Effect of Sodium-Glucose Co-transporter-2 Inhibitors on Ventricular Repolarization Markers in Heart Failure with Reduced Ejection Fraction. Cardiovasc Drugs Ther 38, 327–333 (2024). https://doi.org/10.1007/s10557-022-07396-y

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