Henagliflozin attenuates adverse ventricular remodeling and improves cardiometabolic parameters in patients with type 2 diabetes and hypertension: real-world evidence from a propensity score-matched analysis.

BACKGROUND

Henagliflozin has demonstrated favorable glycemic and metabolic effects in phase III trials. However, real-world evidence regarding its impact on cardiac structure-particularly left ventricular mass index (LVMI)-in patients with type 2 diabetes mellitus (T2DM) and concomitant hypertension remains lacking.

METHODS

In this single-center, retrospective cohort study, 183 patients with T2DM and hypertension were enrolled. After 1:1 propensity score matching, 132 patients (henagliflozin group, n = 66; control group, n = 66) were included in the primary analysis. The henagliflozin group received henagliflozin 10 mg once daily added to standard-of-care therapy, whereas the control group received standard therapy alone. The primary outcome was the change in LVMI from baseline to 6 months. Secondary outcomes included changes in other echocardiographic parameters (LVEF, E/e', left atrial diameter, LVEDd, IVSd, LVPWT), glycemic indices (FPG, HbA1c), blood pressure, body mass index (BMI), inflammatory markers, and renal function.

RESULTS

At 6 months, LVMI decreased in the henagliflozin group (from 87.90 ± 18.32 to 85.28 ± 18.20 g/m2; mean change - 2.62 ± 13.00 g/m2) but increased in the control group (from 83.46 ± 18.22 to 87.81 ± 16.53 g/m2; mean change + 4.35 ± 15.88 g/m2; between-group P = 0.007). Additionally, henagliflozin treatment was associated with significant reductions in left atrial diameter (between-group P = 0.035), E/e' ratio (P = 0.044), interventricular septal thickness (P = 0.030), and left ventricular posterior wall thickness (P = 0.018), as well as a modest increase in LVEF (P = 0.045). Compared with the control group, the henagliflozin group also exhibited greater reductions in fasting plasma glucose (- 0.97 vs. + 0.16 mmol/L; P = 0.037), HbA1c (- 0.42% vs. + 0.04%; P = 0.021), systolic blood pressure (- 9.45 vs. - 1.95 mmHg; P = 0.023), diastolic blood pressure (- 3.38 vs. 0.68 mmHg; P = 0.029), and BMI (- 0.45 vs. 0.00 kg/m2; P = 0.023).

CONCLUSIONS

In patients with T2DM and hypertension, the addition of henagliflozin to standard therapy over 6 months was associated with significant attenuation of adverse ventricular remodeling-as evidenced by reductions in LVMI, left atrial diameter, and diastolic filling indices-alongside clinically meaningful improvements in glycemic control, blood pressure, and body weight.