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. 2022 Aug 23:15:100207.
doi: 10.1016/j.metop.2022.100207. eCollection 2022 Sep.

SGLT2 inhibition reduces myocardial oxygen consumption

Esben Søndergaard  1   2 , Esben S Lauritzen  1 , Katrine M Lauritsen  1   2 , Axel Åkerblom  3 , Pirjo Nuutila  4 , Jonas Oldgren  3 , Lars C Gormsen  5
Affiliations

SGLT2 inhibition reduces myocardial oxygen consumption

Esben Søndergaard et al. Metabol Open. .

Abstract

Aims/hypothesis: SGLT2 inhibition is associated with a reduced risk of cardiac disease that is still largely unexplained. According to one hypothesis, improved myocardial energetics may explain the cardioprotective effects of SGLT2i. However, recent mechanistic studies that have addressed this question have lacked the power to detect discrete but still clinically significant effects.

Methods: We pooled data from two recent randomized clinical trials and performed a meta-analysis to determine the effect of SGLT2 inhibition on myocardial oxygen consumption and myocardial external efficiency measured by positron emission tomography.

Results: SGLT2 inhibition reduced myocardial oxygen consumption (-1.06 [95%CI: 0.22-1.89] mL/100 g/min (n = 59, p = 0.01)), but did not affect myocardial external efficiency (2.22 [95%CI: 0.66-5.11] % (n = 59, p = 0.13)).

Conclusions: /interpretation: SGLT2 inhibition reduces myocardial oxygen consumption at rest, which may contribute to the drugs' cardioprotective effects.

Keywords: Meta-analysis; Myocardial external efficiency; Myocardial oxygen consumption; SGLT2 inhibitors; Type 2 diabetes.

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Conflict of interest statement

JO reports fees to his institution from AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, Novartis, Portola, Pfizer, Roche Diagnostics and Sanofi. AÅ has received speaker's fees and participated in Advisory Board meetings with AstraZeneca. PN reports fees to her institution from AstraZeneca and Glaxo Smith Kline PLCES. ES, ESL, KML and LCG have no financial disclosures.

Figures

Fig. 1
Fig. 1
Meta-analysis of A: Myocardial oxygen consumption (ml/100 g/min), B: Myocardial external efficiency (%) and C: Left ventricular external work (j/g*min). Blue squares represent the mean differences of the individual studies and the horizontal blue lines extending form the blue squares represent the 95% confidence intervals of the difference. The middle of the green diamond represents the pooled mean difference and the width of the green diamond represent the 95% confidence interval of the difference. All meta-analyses were performed with the random-effects model. Heterogeneity is evaluated with τ2, I2 and H2 analyses. “θi = θj” is the chi-squared test for homogeneity. “θ = 0” is the test of the null hypothesis. . (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
See this image and copyright information in PMC

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