Effect of SGLT-2 inhibitors on echocardiographic findings, oxidative stress indicators, endopeptidase enzyme balance and functional capacity in diabetic HEART failure patients

In our study, 56 patients with Low Ejection Fraction Heart Failure (HFrEF) and concomitant Type 2 diabetes who applied to Gaziantep University Şahinbey Practice and Research Hospital between 15.03.2022 and 15.06.2022, and 30 healthy volunteers with no known health problems for randomization were included in our study. We aimed to examine the mechanisms of the effects of 2 inhibitor molecules. In addition, we expanded our study on the echocardiographic detection of the mechanisms of action of these mysterious molecules, which reduce mortality and morbidity. In the patient group; 5 cc venous blood samples were collected twice, at the beginning of the use of SGLT-2 inhibitor drug use and at the 3rd month, and only once at the beginning for normalization from healthy subjects of the same sex control group. In addition to routine transthoracic echocardiographic examination, left ventricular longitudinal and left atrial strain echocardiographic measurements were performed in both groups during the same evaluation. Biochemical parameters, oxidative stress indicators and various endopeptidase enzyme balance (MMP, TIMPs, SESTRIN-2, NRF2, KEAP 1, Asprosin) were studied from venous blood samples taken at the end of the study in Gaziantep University Department of Biochemistry. As a result of our study, when the initial values of the group with heart failure were compared to healthy volunteers; LVEF (Left Ventricular Ejection Fraction), GLS Average (Mean Global Longitudinal Strain), LA Vmax (Left Atrial Maximum Volume), LA Vmin (Left Atrial Minimum Volume), LA EF (Left Atrial Ejection Fraction), LA Strain (Left Atrial Strain) Echocardiography), Sestrin 2 and Asprosin values were statistically significantly decreased. When the baseline values were compared with the 3rd month values following the use of SGLT-2 inhibitor molecules in the heart failure arm of the study, statistically significant increases and decreases were found in; LVEF (Left Ventricular Ejection Fraction), GLS Average (Mean Global Longitudinal Strain), LA Vmax (Left Atrial Maximum Volume), LA Vmin ( Left Atrial Minimum Volume), LA EF (Left Atrial Ejection Fraction), LA Strain (Left Atrial Strain Echocardiography), HbA1C (Glycolized hemoglobin), CRP (C-reactive protein), nt-proBNP (N-terminal pro Brain Natriuretic Peptide), Sestrin 2 and Asprosin values. Keywords: Oxidative Stress in Heart Failure, Type-2 Diabetes, SGLT-2 Inhibitors, Global Longitudinal Strain, Peak Atrial Longitudinal Strain