# Effect of Sodium−Glucose Co‐Transporter‐2 Inhibitor on Estimated Plasma Volume in a Patient With Heart Failure With Reduced Ejection Fraction and a Patient With Heart Failure With Preserved Ejection Fraction

## TL;DR

This paper shows that SGLT2 inhibitors reduce plasma volume in heart failure patients, with bigger drops seen in those with reduced ejection fraction.

## Contribution

Demonstrates SGLT2 inhibitors cause significant plasma volume reduction in heart failure patients using hemoconcentration biomarkers.

## Key findings

- HFrEF patients had -22.56% plasma volume drop after 1 month of SGLT2i treatment
- HFpEF patients showed -6.18% plasma volume reduction after 1 month of SGLT2i
- Biomarkers of hemoconcentration effectively monitored SGLT2i's early plasma volume effects

## Abstract

The increased diuresis after sodium−glucose cotransporter 2 inhibitor (SGLT2i) was associated with a reduction of the estimated plasma volume (ePV) in type 2 diabetic patients.

We hypothesized that the early effect of SGLT2i on ePV may be monitored by the change of biomarkers of hemoconcentration.

We analyzed the early‐ and long‐term effect of SGLT2i empagliflozin on the ePV as assessed by biomarkers of hemoconcentration in a nondiabetic patient with heart failure and reduced ejection fraction (HFrEF) and a nondiabetic patient with heart failure and preserved ejection fraction (HFpEF). The ePV was calculated from hemoglobin and hematocrit levels by Duarte formula and ePV change was calculated by Strauss formula.

The ePV change was −22.56% between baseline and 1 month, and −37.60% between baseline and 12 months follow‐up in a patient with HFrEF, and −6.18% and −16.40% in a patient with HFpEF, respectively.

The early effect of SGLT2i on ePV in patients with heart failure may be monitored by biomarkers of hemoconcentration.

We hypothesized that the early effect of SGLT2i on estimated plasma volume (ePV) may be monitored by biomarkers of hemoconcentration. The ePV change was −22.56% between baseline and 1 month, and −37.60% between baseline and 12 months in patients with HFrEF, and −6.18% and −16.40% in patients with HFpEF, respectively.