Abstract 14114: Sodium-glucose Cotransporter-2 Inhibitors Benefit Cardiac Diastolic Function

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Introduction: Sodium-glucose Cotransporter-2 (SGLT-2) inhibitors are drugs with profound interest because of their beneficial effect on multiple organ systems, including the cardiovascular and renal systems. Their interplay with these systems could prove beneficial in managing complex conditions like heart failure with preserved ejection fraction. We sought to compare cardiac diastolic function in patients on SGLT-2 inhibitors with those on metformin. Methods: Data were collected retrospectively after approval from our institutional review board. The study group included patients on SGLT-2 inhibitors (n=75), and the control group had patients on metformin (n=82), primarily for diabetes mellitus. Patients with ejection fraction less than 50% were excluded from the study. Data collected included age, systolic blood pressure (SBP), left ventricular (LV) ejection fraction, LV and left atrial dimensions, and diastolic parameters. Mean values, along with standard deviation, were calculated. Multivariate regression analysis for diastolic function was performed while adjusting for confounders, including age, body mass index, and SBP. Results: Study group showed better diastolic function as evidenced by significantly higher e’ medial (6.8 v/s 6.16 cm/s; p = 0.03) and e’ lateral (9.8 v/s 7.9 cm/s; p=0.008) when compared to the control group. E/e’, a marker of pulmonary capillary wedge pressure, was lower in the study group (12.87 v/s 14.36; p=0.08); however, it did not reach statistical significance. LA volume index was significantly lower in the study group, suggestive of favorable hemodynamic status (26.5 v/s 29.6 mL/m 2 ; p=0.03). SBP was significantly lower in the study group (127 v/s 135 mm Hg; p=0.01). Multivariate regression model demonstrated SBP as a significant confounder that contributed to e’ (average) difference between the two groups. Conclusions: SGLT-2 inhibitors favored better diastolic measurements when compared with metformin alone. The mechanism may be attributed to its BP-lowering effect. A larger prospective study is required to determine the role of SGLT-2 inhibitors.