The effect of SGLT2 inhibitors on cardio-electrophysiological balance index in diabetic patients with preserved ejection heart failure

Abstract

Background: Type 2 diabetes mellitus (DM) increases the risk of heart failure with preserved ejection fraction (HFpEF). The use of sodium-glucose co-transporter-2 (SGLT-2) inhibitors, which have been shown to have cardioprotective effects in HFpEF, has increased in frequency. The index of cardio-electrophysiological balance (iCEB) is a marker that can be calculated on electrocardiography (ECG) and has been proven to be a good predictor of ventricular arrhythmia. This study aimed to investigate the effects of SGLT-2 inhibitors on iCEB and iCEBc in type 2 DM patients with HFpEF. Methods: We retrospectively analyzed the data of 76 patients with type 2 DM with HFpEF who were started on SGLT-2 inhibitors. We compared the ECG parameters obtained at baseline and six-month follow-up. Results: The mean age of the patients included in the study was 64.7±8.9 years. When ECG parameters before and after treatment were compared, iCEB (4.33±1.95 vs. 4.24±1.50, p= 0.006) and iCEBc (4.67±1.35 vs. 4.59±1.36, p<0.001) values were found to be decreased compared to before treatment. Conclusion: The iCEB and iCEBc values of the patients decreased significantly after SGLT-2 inhibitors. These results suggest that SGLT-2 inhibitors may reduce the risk of ventricular arrhythmia in patients with HFpEF.