Open Access

REVIEW

Sodium-Glucose Cotransporter 2 Inhibitors in Adult and Pediatric Congenital Heart Disease: Review of Emerging Data and Future Directions

William H. Marshall V^1,2,*, Lydia K. Wright²
1 Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
2 The Heart Center, Nationwide Children’s Hospital, Columbus, OH 43205, USA
* Corresponding Author: William H. Marshall V. Email:

Congenital Heart Disease https://doi.org/10.32604/chd.2024.056608

Received 26 July 2024; Accepted 18 September 2024; Published online 27 September 2024

Abstract

Heart failure (HF) is common in patients with congenital heart disease (CHD) and there are limited medical therapies. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a proven medical therapy in patients with acquired HF, though data are limited in patients with CHD. The aim of this review is to summarize the current evidence for use of SGLT2i in patients with CHD and identify future directions for study. In available publications, SGLT2i in patients with CHD seem to be well tolerated, with similar side effect profile to patients with acquired HF. Improvement in functional capacity and natriuretic peptides are mixed, though there is a signal for potential reduction in HF hospitalizations. One prospective study in patients with systemic right ventricles showed an improvement in systolic function for patients already on maximal HF medical therapy. Though limited, there is emerging data on use of SGLT2i in pediatric patients with CHD and HF. Future prospective studies are needed to evaluate for clinically meaningful endpoints, including HF hospitalization, as well as evaluate the hemodynamic impact in subtypes of CHD at high risk for HF.

---

Keywords

Congenital heart disease; heart failure; sodium-glucose 2 cotransporter inhibitors; systemic right ventricle; Fontan

---