The effect of SGLT2 inhibitors in peripheral tissue oxygenation in patients with heart failure; A Near-infrared spectroscopy study
C Kourek, G Velissaris, D Chatzis, N Papaioannou, N Biagkis, K Mpirmpilis, E Karatzanos, A Tasoulis, K Bratis, M Pentaris, Z Morou, S Mykoniati, S Papaioannou, C Skopelitis, A NtalianisAbstract
Background
SGLT2 inhibitors exert pleiotropic effects in patients with heart failure (HF). It is still debatable whether they improve significantly microcirculatory dysfunction and tissue oxygenation.
Purpose
To study the effect of SGLT2 inhibitors on peripheral microcirculation and tissue oxygenation in patients with HF.
Methods
Near-infrared spectroscopy was applied prospectively in 22 consecutive patients with HF (left ventricular ejection fraction < 50%) before and 12 months after the administration of SGLT inhibitors. The following 4 parameters were determined with NIRS: a) the baseline tissue oxygenation (STO2) b) the occlusion slope [the rate of tissue desaturation after occlusion (Occl slope)], c) the recovery slope (the slope of the hyperemic tissue oxygenation pattern after occlusion (Rec slope), d) the time of hyperemic tissue oxygenation after occlusion (Hyper time). At the same time points, NTproBNP and 6 min were also performed.
Results
The study population was consisted of 11 patients with HFrEF and 11 patients with HFmrEF (mean NYHA class 2.86±0.8, NT-proBNP levels 1540±1710 pg/Dl, 6 min walk test distance 426±130 m). A significant reduction of the NT-proBNP levels (figure 1) and a marginally non statistically significant increase in 6 min walk test distance was observed at the end of the study. Furthermore, a significant decrease of the Occl slope and a significant increase of the Hyper time was noted (figure 2).
Conclusions
SGLT2 inhibitors improve significantly the peripheral tissue oxygenation in patients with heart failure. This study outlines possible beneficial mechanistic effects of SGLT2 inhibitors in microcirculation which might play a role on the improvement of heart performance in patients with HF.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.