Ertugliflozin Significantly Reduces Functional Mitral Regurgitation in Heart Failure patients : Study
Researchers have found that ertugliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, significantly improves left ventricular global longitudinal strain and left atrial remodeling, and reduces functional mitral regurgitation (MR) in patients with heart failure (HF). The EFFORT trial assessed the efficacy of ertugliflozin for the reduction of functional MR associated with HF and mild to moderately reduced ejection fraction, offering a potential new treatment option for patients. This study was published in the journal Circulation by Kang and colleagues.
Functional mitral regurgitation (MR) is a common complication in patients with heart failure (HF), contributing to significant morbidity and mortality despite standard medical therapy. The EFFORT trial was a multicenter, double-blind, randomized study examining whether ertugliflozin could improve MR in patients with HF, New York Heart Association functional class II or III, and an ejection fraction between 35% and 50%.
A total of 128 patients were randomly assigned to receive either ertugliflozin or placebo, in addition to guideline-directed medical therapy for HF. The primary endpoint was a change in the effective regurgitant orifice area of functional MR from baseline to the 12-month follow-up. Secondary endpoints included changes in regurgitant volume, left ventricular (LV) volume indices, left atrial volume index, LV global longitudinal strain, and NT-proBNP (N-terminal pro-B-type natriuretic peptide).
The key findings of the study were as follows:
• The treatment groups were well-matched in baseline characteristics, with mean age 66±11 years and 61% male participants.
• The decrease in the effective regurgitant orifice area was significantly greater in the ertugliflozin group compared to the placebo group (−0.05±0.06 versus 0.03±0.12 cm2; P<0.001).
• Ertugliflozin was associated with a reduction in regurgitant volume by 11.2 mL (95% CI, −16.1 to −6.3; P=0.009), a decrease in the left atrial volume index by 6.0 mL/m2 (95% CI, −12.16 to 0.15; P=0.005), and improved LV global longitudinal strain by 1.44% (95% CI, −2.42% to −0.46%; P=0.004).
• There were no significant between-group differences in LV volume indices, ejection fraction, or NT-proBNP levels.
• Serious adverse events occurred in 1.6% of ertugliflozin group participants versus 9.2% of the placebo group (P=0.12).
Ertugliflozin demonstrated significant improvement in left ventricular global longitudinal strain and left atrial remodeling, as well as a reduction in functional MR in patients with HF. Sodium-glucose cotransporter 2 inhibitors like ertugliflozin may offer a novel therapeutic approach for patients with functional MR.
Reference:
Duk-Hyun Kang, MD, PhD, Sung-Ji Park, MD, PhD, Sung-Hee Shin, MD, PhD, In-Chang Hwang, MD, Yeonyee Elizabeth Yoon, MD, PhD, Hyung-Kwan Kim, MD, PhD, Mijin Kim, MD, PhD, Min-Seok Kim, MD, PhD, Sung-Cheol Yun, PhD, Jong-Min Song, MD, PhD, Seok-Min Kang, MD, PhD Ertugliflozin for Functional Mitral Regurgitation Associated With Heart Failure: EFFORT TrialCirculation. 2024;149:00–00. DOI: 10.1161/CIRCULATIONAHA.124.069144
