Clinical Trials Logo

Clinical Trial Summary

To evaluate the efficacy of SGLT2 inhibitors on left ventricular global longitudinal strain and diastology parameters among diabetic and non-diabetic patients with chronic heart failure


Clinical Trial Description

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have an established place in the therapy of heart failure (HF), as they have been shown to significantly reduce all-cause mortality, cardiovascular mortality, and hospitalizations in HFrEF patients, regardless of the presence of diabetes mellitus. The growing evidence of the effect of SGLT2i on cardiac remodeling through cellular, molecular, vascular, interstitial, and electrical effects justifies its role as fundamental HF therapy. SGLT2 inhibition in heart failure promotes reverse cardiac remodeling and is associated with better clinical outcomes. Adverse myocardial remodeling affecting the left ventricle is a key factor in HF progression, and current well-established HF phenotypes are based on LVEF. However, other relevant players, such as the left atrium, have received less attention. Indeed, the left atrium plays a critical role in cardiac function, particularly in left ventricular (LV) filling during diastole. Additionally, atrial dysfunction can directly lead to pulmonary congestion. Left atrial (LA) remodeling occurs in HF irrespective of the degree of LV systolic dysfunction and can be observed in the presence of preserved or reduced LVEF. SGLT2 inhibition has been associated with reduced left ventricular (LV) and left atrial volumes in HF; however, its relationship with contemporary echocardiographic parameters of global LV systolic function, including global longitudinal strain and myocardial work, has not been thoroughly investigated. Measuring the effect of SGLT2i therapy on left ventricular systolic function (LV) has previously been assessed by changes in heart size volume and ejection fraction. In current clinical practice, the assessment of LV systolic function is still mainly based on the measurement of LV ejection fraction (LVEF), which remains the gold standard despite some notable limitations. In the last decade, LV global longitudinal strain (GLS) has emerged as a more accurate predictor of poor outcomes, revealing subtle abnormalities and preclinical LV systolic dysfunction. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT06137430
Study type Observational
Source Assiut University
Contact Ahmad Abd eltwab Abd elzaher, GP
Phone 01001806037
Email ahmedabdeltwab777@gmail.com
Status Not yet recruiting
Phase
Start date December 1, 2023
Completion date December 31, 2024

See also
  Status Clinical Trial Phase
Completed NCT03339310 - Evaluation of the Safety and Efficacy of the 2-lead OPTIMIZER® Smart System N/A
Completed NCT03773991 - Dyspnea Assessment in Hemodialysis Patients
Completed NCT01032395 - Immunogenicity, Safety, and Tolerability of an MF59-Adjuvanted Versus Non-Adjuvanted Influenza Vaccines in Patients With Chronic Pulmonary Disease, Chronic Heart Disease, or Diabetes Mellitus Phase 3
Active, not recruiting NCT03018717 - Integral Clinical Plan Shared With or Without Telemonitoring of Constants in Patient With Chronic Diseases N/A
Terminated NCT03102437 - Continued Access Protocol for the Evaluation of the OPTIMIZER Smart System N/A
Recruiting NCT03966729 - Relationships and Differences Analysis in Heart Failure