SYSTEMIC AND PULMONARY HEMODYNAMIC EFFECTS OF SGLT2 INHIBITORS IN HEART FAILURE WITH COEXISTING LUNG DISEASE
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Keywords
SGLT2 inhibitors, heart failure, pulmonary hypertension, chronic lung disease, hemodynamics, right ventricular function, NT-proBNP
Abstract
Background: To evaluate the systemic and pulmonary hemodynamic effects of SGLT2 inhibitors in patients with chronic HF and coexisting lung disease.
Methods: This prospective observational study included 72 patients with HF and chronic lung disease treated at Gomal Medical College and its affiliated hospital between January 2023 and January 2024. Baseline and six-month follow-up assessments included clinical evaluation, echocardiographic measurements of systemic and pulmonary pressures, pulmonary function tests, NT-proBNP levels, and six-minute walk distance (6MWD). Statistical comparisons were made using paired t-tests and McNemar’s test.
Results: Mean systolic and diastolic blood pressures decreased significantly after therapy (128.4 ± 12.7 to 122.1 ± 11.9 mmHg, p = 0.004; 78.5 ± 8.4 to 74.9 ± 7.8 mmHg, p = 0.011), while cardiac output increased (4.21 ± 0.82 to 4.56 ± 0.87 L/min, p = 0.022). Pulmonary artery systolic pressure and mean pulmonary artery pressure declined (p < 0.001 for both), alongside reductions in ‘pulmonary vascular resistance and pulmonary capillary wedge pressure’. NT-proBNP levels fell significantly (1832 ± 651 to 1427 ± 604 pg/mL, p < 0.001), and 6MWD improved by a mean of 34 meters (p < 0.001). Pulmonary function parameters showed no significant change.
Conclusion: In HF patients with chronic lung disease, SGLT2 inhibitors improved both systemic and pulmonary hemodynamics, enhanced exercise capacity, and reduced cardiac biomarker levels without adversely affecting lung function. These findings support their role as a valuable addition to therapy in this complex patient group.
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Dr Muhammad Imran Ullah
Assistant Professor, Department of Medicine, Gomal Medical College - MTI, DI Khan, Pakistan
Dr Muhammad Fawad
Assistant Professor, Department of Medicine, Gomal Medical College - MTI, DI Khan, Pakistan
Dr Ihsan Ullah
Assistant Professor, Department of Pharmacology, Saidu Medical College, Swat, Pakistan
Dr Hina Umair
Assistant Professor, Department of Physiology, Wah Medical College, NUMS, Wah Cantt, Pakistan
Dr Falak Naz
Assistant Professor, Department of Pharmacology, Northwest School of Medicine, Peshawar, Pakistan
Dr Ameer Hamza
Lecturer, Department of Pharmacology, Peshawar Medical College, Peshawar, Pakistan