Purpose

The use of sodium-glucose-cotransporter-type-2 inhibitors (SGLT2i) was associated in previous studies with an improved vascular function in non-human experimental models. We therefore sought to evaluate possible changes in endothelial function assessed by flow-mediated dilation (FMD) in patients with chronic heart failure (CHF) and type-2 diabetes mellitus (T2DM), switching from other oral hypoglycemic agents to SGLT2i in an observational study.

Methods

Twenty-two consecutive outpatients with CHF and T2DM were enrolled after switching to SGLT2i therapy, and compared with 23 consecutive controls from the same registry comparable for principal clinical characteristics. In all patients, endothelial function was assessed by FMD at baseline and after 3 months of follow-up.

Results

Three months of therapy with SGLT2i were associated with a statistically significant improvement in endothelial function (19.0 ± 5.7% vs 8.5 ± 4.1%, p < 0.0001); baseline levels of FMD were comparable between groups (p n.s.). Therapy with SGLT2i was significantly associated to improved FMD levels even at multivariable stepwise regression analysis (p < 0.001).

Conclusions

Switch to SGLT2i in patients with CHF and T2DM was associated in an observational non-randomized study with an improved endothelial function.

中文翻译：

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换用 SGLT2 抑制剂并改善慢性心力衰竭糖尿病患者的内皮功能

目的

在之前的研究中，钠-葡萄糖-协同转运蛋白 2 型抑制剂 (SGLT2i) 的使用与非人类实验模型中血管功能的改善有关。因此，我们试图评估慢性心力衰竭 (CHF) 和 2 型糖尿病 (T2DM) 患者通过血流介导扩张 (FMD) 评估的内皮功能可能发生的变化，在一项观察性研究中从其他口服降糖药转换为 SGLT2i .

方法

22 名连续的 CHF 和 T2DM 门诊患者在转为 SGLT2i 治疗后被纳入，并与来自同一登记处的 23 名连续对照患者的主要临床特征进行比较。在所有患者中，在基线时和随访 3 个月后通过 FMD 评估内皮功能。

结果

三个月的 SGLT2i 治疗与内皮功能的统计学显着改善相关（19.0 ± 5.7% 对比 8.5 ± 4.1%，p  < 0.0001）；FMD 的基线水平在组间具有可比性 (p ns)。即使在多变量逐步回归分析中，SGLT2i 疗法也与改善 FMD 水平显着相关 ( p  < 0.001)。

结论

在一项观察性非随机研究中，CHF 和 T2DM 患者改用 SGLT2i 与内皮功能改善相关。