Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

By Yu H
Published August 17, 2020

Key Takeaways

Per recently findings from the DAPAHF and EMPA-REG clinical trials, the Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) class of drugs aid in decreasing the heart failure with reduced ejection fraction (HFrEF) hospitalization and reducing the risk of worsening HF or death. There is uncertainty concerning the hemodynamic mechanisms of SGLT2i underlying the DAHAHF results despite the beneficial outcomes observed clinically. Researchers here adopted a proposed cardio-renal mathematical model and improved it to determine the state of HFrEF and cardiac therapeutic responses. Further, they prospectively simulate the effect of SGLT2i on cardiac hemodynamics and volume status, in order to better ascertain the mechanisms underlying observed decreases in HF hospitalization and cardiovascular death observed with SGLT2i. They carried out validation studies by replicating the improvements in cardiac functions in the enalapril arm of the SOLVD clinical trial. They investigated how SGLT2i affects cardiac and renal functional interactions. Per observations, SGLT2i results in reduction left ventricle (LV) end-diastolic volume/pressure (EDV/EDP), and this preload reduction leads to slowing of cardiac remodeling and progression over 1 year. Further, they suggest that SGLT2i may decrease interstitial congestion without inducing large decreases in blood volume.

Read the full article on PLoS Neglected Tropical Diseases.

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