# Invasive Hemodynamic Changes Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

## TL;DR

This study reviews how SGLT2 inhibitors affect heart function, suggesting they may reduce pressure in the heart's blood vessels.

## Contribution

The study provides new insights into how SGLT2 inhibitors may benefit heart failure through hemodynamic changes.

## Key findings

- SGLT2 inhibitors significantly reduced pulmonary capillary wedge pressure at rest and during exercise.
- There was a non-significant reduction in mean pulmonary artery pressure with SGLT2 inhibitors.
- The findings suggest a possible mechanism for the heart failure benefits of SGLT2 inhibitors.

## Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to lower incident heart failure (HF) and HF hospitalizations, but the mechanisms of benefit in relation to invasive hemodynamics remain unclear. Using PRISMA guidelines, we systematically reviewed multiple online databases for randomized trials evaluating the effect of SGLT2i on invasive hemodynamics. Rest and peak exercise invasive hemodynamics were measured via right heart catheterization pre- and postintervention. Random effects model meta-analysis at a 95% confidence interval was done using RevMan 5.0. A total of 3 studies with a total of 145 patients were included in the meta-analysis. SGLT2i was significantly associated with a reduction in pulmonary capillary wedge pressure at rest and peak exercise. Similarly, SGLT2i reduced mean pulmonary artery pressure at rest and peak exercise, respectively; however, this was not statistically significant. This hypothesis-generating study offers mechanistic insights into the central hemodynamic effects of SGLT2i underpinning the HF benefits of SGLT2i.