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Meta-Analysis Evaluating the Effect of Sodium-Glucose Co-Transporter-2 Inhibitors on Pulmonary Artery Pressure Indices

      Pulmonary artery (PA) pressure indexes have been shown to be highly predictive of surrogate cardiovascular outcomes, including cardiovascular mortality, especially in patients with heart failure (HF) or chronic kidney disease.
      • Dalos D
      • Mascherbauer J
      • Zotter-Tufaro C
      • Duca F
      • Kammerlander AA
      • Aschauer S
      • Bonderman D.
      Functional status, pulmonary artery pressure, and clinical outcomes in heart failure with preserved ejection fraction.
      • Abraham WT
      • Stevenson LW
      • Bourge RC
      • Lindenfeld JA
      • Bauman JG
      • Adamson PB
      CHAMPION Trial Study Group
      Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial.
      • Bolignano D
      • Lennartz S
      • Leonardis D
      • D'Arrigo G
      • Tripepi R
      • Emrich IE
      • Mallamaci F
      • Fliser D
      • Heine G
      • Zoccali C
      High estimated pulmonary artery systolic pressure predicts adverse cardiovascular outcomes in stage 2–4 chronic kidney disease.
      Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have shown outstanding cardiovascular and renal benefits in patients with type 2 diabetes mellitus (T2DM),
      • Zelniker TA
      • Wiviott SD
      • Raz I
      • Im K
      • Goodrich EL
      • Bonaca MP
      • Mosenzon O
      • Kato ET
      • Cahn A
      • Furtado RHM
      • Bhatt DL
      • Leiter LA
      • McGuire DK
      • Wilding JPH
      • Sabatine MS.
      SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials [published correction appears in Lancet 2019;393:30].
      whereas, these effects are sustained in patients with HF or chronic kidney disease regardless of T2DM status. However, mechanisms underlying these beneficial effects remain largely unknown.
      • Cowie MR
      • Fisher M.
      SGLT2 inhibitors: mechanisms of cardiovascular benefit beyond glycaemic control.
      Although it is established that SGLT-2 inhibitors improve left ventricular remodeling,
      • Zhang DP
      • Xu L
      • Wang LF
      • Wang HJ
      • Jiang F.
      Effects of antidiabetic drugs on left ventricular function/dysfunction: a systematic review and network meta-analysis.
      their effect on right ventricular function and pulmonary vasculature are not known. Therefore, we sought to assess whether SGLT-2 inhibitors affect PA pressure (PAP) indexes in patients at high cardiovascular risk or with established cardiovascular disease.
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      References

        • Dalos D
        • Mascherbauer J
        • Zotter-Tufaro C
        • Duca F
        • Kammerlander AA
        • Aschauer S
        • Bonderman D.
        Functional status, pulmonary artery pressure, and clinical outcomes in heart failure with preserved ejection fraction.
        J Am Coll Cardiol. 2016; 68: 189-199
        • Abraham WT
        • Stevenson LW
        • Bourge RC
        • Lindenfeld JA
        • Bauman JG
        • Adamson PB
        • CHAMPION Trial Study Group
        Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial.
        Lancet. 2016; 387: 453-461
        • Bolignano D
        • Lennartz S
        • Leonardis D
        • D'Arrigo G
        • Tripepi R
        • Emrich IE
        • Mallamaci F
        • Fliser D
        • Heine G
        • Zoccali C
        High estimated pulmonary artery systolic pressure predicts adverse cardiovascular outcomes in stage 2–4 chronic kidney disease.
        Kidney Int. 2015; 88: 130-136
        • Zelniker TA
        • Wiviott SD
        • Raz I
        • Im K
        • Goodrich EL
        • Bonaca MP
        • Mosenzon O
        • Kato ET
        • Cahn A
        • Furtado RHM
        • Bhatt DL
        • Leiter LA
        • McGuire DK
        • Wilding JPH
        • Sabatine MS.
        SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials [published correction appears in Lancet 2019;393:30].
        Lancet. 2019; 393: 31-39
        • Cowie MR
        • Fisher M.
        SGLT2 inhibitors: mechanisms of cardiovascular benefit beyond glycaemic control.
        Nat Rev Cardiol. 2020; 17: 761-772
        • Zhang DP
        • Xu L
        • Wang LF
        • Wang HJ
        • Jiang F.
        Effects of antidiabetic drugs on left ventricular function/dysfunction: a systematic review and network meta-analysis.
        Cardiovasc Diabetol. 2020; 19: 10
        • Nassif ME
        • Qintar M
        • Windsor SL
        • Jermyn R
        • Shavelle DM
        • Tang F
        • Lamba S
        • Bhatt K
        • Brush J
        • Civitello A
        • Gordon R
        • Jonsson O
        • Lampert B
        • Pelzel J
        • Kosiborod MN.
        Empagliflozin effects on pulmonary artery pressure in patients with heart failure: results From the EMBRACE-HF trial.
        Circulation. 2021; 143: 1673-1686
        • Omar M
        • Jensen J
        • Frederiksen PH
        • Kistorp C
        • Videbæk L
        • Poulsen MK
        • Möller S
        • Ali M
        • Gustafsson F
        • Køber L
        • Borlaug BA
        • Schou M
        • Møller JE.
        Effect of empagliflozin on hemodynamics in patients with heart failure and reduced ejection fraction.
        J Am Coll Cardiol. 2020; 76: 2740-2751
        • Wolsk E
        • Jürgens M
        • Schou M
        • Ersbøll M
        • Hasbak P
        • Kjær A
        • Zerahn B
        • Høgh Brandt N
        • Haulund Gæde P
        • Rossing P
        • Faber J
        • Inzucchi SE
        • Kistorp CM
        • Gustafsson F
        A randomized controlled trial of the hemodynamic effects of empagliflozin in patients with type 2 diabetes at high cardiovascular risk (the SIMPLE Trial) [published online January 21].
        Diabetes. 2022; https://doi.org/10.2337/db21-0721