SGLT2 inhibitor shows promise for functional mitral regurgitation in HF patients

Among patients with functional mitral regurgitation (MR) associated with heart failure (HF), ertugliflozin led to significant improvement in left ventricular (LV) global longitudinal strain and left atrial remodeling, and reduced functional MR.

• The multicenter, double-blind, randomized EFFORT (Ertugliflozin for Functional Mitral Regurgitation) trial enrolled patients with MR and HF (NYHA functional class II or III), ejection fraction (EF) between 35% and 50%, and effective regurgitant orifice area of chronic functional MR >0.1 cm^2 on baseline echo. A total of 128 patients were assigned to receive either ertugliflozin or placebo in addition to guideline-directed medical therapy for HF.
• Decrease in effective regurgitant orifice area at 12-month follow-up was significantly greater in the ertugliflozin group vs. the placebo group (-0.05±0.06 vs. 0.03±0.12 cm^2; P<0.001). Relative to placebo, ertugliflozin significantly reduced regurgitant volume by 11.2 mL, left atrial volume index by 6.0 mL/m^2, and LV global longitudinal strain by 1.44%. The rate of serious adverse events was 1.6% in the ertugliflozin group vs. 9.2% in the placebo group (P=0.12).
• Given the findings, authors conclude that SGLT2 inhibitors may be considered for patients with functional MR.

Source:

Kang DH, et al. (2024, May 1). Circulation. Ertugliflozin for Functional Mitral Regurgitation Associated With Heart Failure: EFFORT Trial. https://pubmed.ncbi.nlm.nih.gov/38690659/