Effects of SGLT2 Inhibitors on Left Ventricular Ejection Fraction (LVEF) in Coronary Patients: A Prospective Single-center Study

Abstract

Objective: To evaluate the effect of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on left ventricular ejection fraction (LVEF) in coronary patients, whether revascularized or not. Methods: A prospective single-center study was conducted in 100 patients with ischemic cardiomyopathy and moderate or mildly reduced systolic function (LVEF > 30%), treated with empagliflozin or dapagliflozin during the acute phase of the vascular event. Clinical and echocardiographic follow-up was performed at baseline and at 6 months, including assessment of LVEF, ventricular volumes, global longitudinal strain, and NT-proBNP levels. The study group includes 51% of diabetic patients, with a mean age of 54 YO, the results were meant to specify whether there were clinical and echocardiographic improvement, regardless of the diabetes status and revascularization mode.  Results: After 6 months, a significant improvement in LVEF (+3.2%, p < 0.01), reductions in LVEDV (–15 ml) and LVESV (–12 ml) (p < 0.05), and an improvement in strain (+2.8%) were observed. NT-proBNP decreased by 18% (p = 0.07) Adverse effects were minimal (5% mild dehydration). Conclusion: SGLT2 inhibitors promote favorable ventricular remodeling in coronary patients, even in the absence of heart failure or diabetes, with improved LVEF and structural parameters and excellent tolerability. These findings support the systematic use of SGLT2i in this population.