Beneficial effects of sodium glucose cotransporter 2 inhibitors on left ventricular mass in patients with diabetes mellitus.

Background Sodium-glucose co-transporter 2 inhibitor (SGLT2i) has recently been suggested to reduce the risk of cardiovascular events. Left ventricular hypertrophy (LVH) is associated with cardiovascular events. Diabetic macroangiopathy is a crucial complication in patients with diabetes mellitus (DM). This study examined the effect of SGLT2i on LVH in patients with type 2 DM (T2DM). Methods The retrospective cohort study was conducted in consecutive outpatients with T2DM from 2010 to 2020. Left ventricular mass index (LVMI) was used as an indicator of LVH based on echocardiography. The minimum follow-up period was 1 year. After propensity score-matching for clinical profiles, patients who underwent annual echocardiography twice for a routine check-up and took SGLT2i were defined to the SGLT2i group, whereas patients without SGLT2 inhibitors were defined to the non-SGLT2 group. SGLT2i was administered after baseline echocardiography followed by a second examination. Results LVMI levels in the SGLT2i group (n=169) significantly decreased from baseline compared with those in the non-SGLT2i group (n=169), % changes in LVMI2.7(g/m2.7 ) in median (interquartile ranges: IQR) were -7.7 (-18.7, 2.5) vs -3.6 (-14.3, 5.8), respectively, P =0.017). In a subgroup analysis, LVMI levels in the patients who had LVH in the SGLT2i group more significantly decreased than those without LVH, % changes in LVMI2.7(g/m2.7 ) in median (IQR) were: -13.5 (-22.1, -2.4) vs -2.8 (-12.6, 9.8), respectively, P Conclusions SGLT2i treatment was shown to improve LVH in patients with T2DM and may play a pivotal role in the future treatment of diabetic cardiovascular complications. Highlights We evaluated Japanese patients with type 2 diabetes mellitus (T2DM) for the effect of sodium-glucose co-transporter 2 inhibitor (SGLT2i) on left ventricular hypertrophy (LVH). Left ventricular mass index (LVMI) was used as an indicator of LVH. LVMI levels significantly decreased after administration of SGLT2i. After SGLT2i treatment, LVMI levels in the patients who had LVH significantly decreased compared with patients without LVH. SGLT2i was therefore shown to improve LVH in patients with T2DM.