Shedding light on the effects of sodium-glucose cotransporter 2 inhibitors in the early stages of heart failure

Table 1 Main studies evaluating the effects of sodium-glucose cotransporter 2 inhibitors on biomarkers and echocardiographic parameters in patients at risk for or with pre-heart failure

Ref.	Year	Study design	Cohort	Mean HbA1c	Prevalent SGLT2i	Main outcomes
Iannantuoni et al[13]	2019	Single-center, prospective, observational	15 T2DM patients	After 6 months, 8% to 7%	Empagliflozin	After 6 months, hsCRP decrease1, MPO decrease1, IL-10 increase1, GSR increase1, CAT mRNA increase1, GSH increase1
Brown et al[17]	2021	Single-center, prospective, randomized, double-blind, placebo-controlled	47 T2DM patients with LVH	NA	Dapagliflozin	After 12 months, GLS increase1
Rau et al[21]	2021	Single-center, prospective, double-blind, placebo-controlled, parallel groups, randomized	42 T2DM patients	After 3 months, 7.5% to 7.1%	Empagliflozin	After 3 months, E decrease1, E/A decrease1, E/e’ decrease1
Shim et al[20]	2021	Single-center, prospective, randomized, double-blind, placebo-controlled	58 T2DM patients with at least grade I diastolic dysfunction	NA	Dapagliflozin	After 6 months, DR25W increase1, DR50W increase1, e’25W increase1, E/e'50W decrease1
Lin et al[19]	2024	Single-center, prospective, open-label, randomized, active-controlled	76 T2DM patients	After 6 months, 7.8% to 7.1%	Dapagliflozin	After 6 months, LVESV decrease1, LVMI decrease1, LVDd decrease1
Gherbon et al[14]	2024	Single-center, retrospective	200 T2DM patients	After 12 months, 8.4% to 7.3%	Dapagliflozin, Empagliflozin	After 12 months, CRP decrease1, SBP decrease1, DBP decrease1, NT-proBNP decrease1
Wang et al[15]	2024	Single-center, prospective, randomized, double-blind, placebo-controlled	62 T2DM patients	NA	Dapagliflozin	After 12 months, IL-1B decrease1, PBMC decline1
Dihoum et al[18]	2024	Single-center, prospective, randomized, double-blind, placebo-controlled	60 T2DM patients with LVH	After 12 months, 7.8% to 7.2%	Dapagliflozin	After 12 months, CRP decrease1, IL-1B decrease, LVM decrease1, GLS increase1
Grubić Rotkvić et al[11,12]	2024	Two-center, prospective, non-randomized	64 T2DM patients	After 6 months, 8.5% to 6.7%	Dapagliflozin, Empagliflozin	After 6 months, decrease IVST decrease1, E/e’ decrease1, decT decrease1, SVi increase1, GLS increase, hsCRP and MPO decrease

¹P < 0.05.

HbA1c: Hemoglobin A1c; SGLT2i: Sodium-glucose cotransporter 2 inhibitors; T2DM: Type 2 diabetes mellitus; hsCRP: High-sensitivity C-reactive protein; MPO: Myeloperoxidase; IL: Interleukin; GSR: Glutathione S-reductase; CAT: Catalase; GSH: Glutathione; LVMI: Left ventricular mass index; GLS: Global longitudinal strain; DR: Diastolic reserve; LVESV: Left ventricular end-systolic volume; LVDd: Left ventricular diastolic diameter; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; NT-proBNP: N-terminal B-type natriuretic peptide; PBMC: Peripheral blood mononuclear cell; LVH: Left ventricular hypertrophy; LVM: Left ventricular mass; IVST: Interventricular septum thickness; decT: Deceleration time; SVi: Stroke volume index; NA: Not applicable.