Effects of SGLT2 inhibitors on heart failure symptoms, quality of life and exercise capacity in patients with heart failure and preserved ejection fraction: A meta-analysis

Abstract

Introduction: Patients with HFpEF usually have severe exercise intolerance which leads to poor quality of life.While SGLT2 inhibitors in HFrEF patients have been proven beneficial, with HFpEF it remains uncertain. This meta-analysis aimed to determine the outcomes of heart failure symptoms, exercise capacity, and quality of life in patients on SGLT2 inhibitors. Methods: The studies included only RCTs. Eligible studies were appraised using the CASP RCT Standard Checklist. Outcomes expressed as mean difference (MD) between placebo group and SGLT-2 inhibitors group after 12 weeks in the Kansas City Cardiomyopathy Questionnaire Total Summary Score (KCCQ-TSS), Clinical Symptoms score (KCCQ-CS), Overall symptoms score (KCCQ-OS) and 6-minute walk test distance (6MWTD) were the main effect measures. Results: Three RCTs with a total of 6,617 HFpEF patients were included in this meta-analysis. The patients on SGLT2-inhibitors showed improvement of HF symptoms and Quality of life based on KCCQ-TSS 2.68 (95% CI 0.78, 4.57), KCCQ-CS MD 2.60 (95%, CI 1.56, 3.63), KCCQ-OS MD 2.18 (95% CI 0.56, 3.8) and exercise capacity assessed by the 6-MWTD with MD 17.47 (95% CI 6.46, 28.48). Conclusion: This meta-analysis showed that there was significant improvement in the heart failure symptoms, Quality of life and exercise capacity in patients taking SGLT2 inhibitors.