{"id":"5782603a2a90","type":"article","url":"https://hartvaat.nl/2026/10/01/sglt2-remmers-verbeteren-ventriculaire-elektrische-stabiliteit-op-ecg-meta-analy/","title":"SGLT2-remmers verbeteren ventriculaire elektrische stabiliteit op ECG — meta-analyse","title_en":"Effect of sodium-glucose cotransporter-2 inhibitors on electrocardiographic markers of ventricular repolarization: A systematic review and meta-analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"American heart journal plus : cardiology research and practice","doi":"10.1016/j.ahjo.2026.100888","source_url":"https://doi.org/10.1016/j.ahjo.2026.100888","authors":["Muhammad Ghifari Karsa","Viyola Rahma","Muhammad Iqhramullah","Muhammad Habiburrahman"],"significance":5,"published":"2026-09-26","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/","https://hartvaat.nl/kennis/farmacologie/sglt2-remmers-farmacologie/"],"congress":"","summary_en":"A systematic review and meta-analysis of 17 studies (5,022 patients) demonstrates that SGLT2 inhibitors significantly reduce electrocardiographic markers of ventricular repolarization dispersion, including QTc (MD -4.9 ms) and Tp-e (MD -6.12 ms). These electrophysiological improvements were most pronounced at 6 months and occurred without affecting heart rate or conduction intervals. The findings provide a mechanistic explanation for the reduced risk of sudden cardiac death and ventricular arrhythmias observed in cardiovascular outcome trials, reinforcing the broader cardioprotective profile of SGLT2 inhibitors in heart failure and cardiometabolic disease.","created":"2026-09-20T00:46:10Z","updated":"2026-09-20T00:46:10Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een systematische review en meta-analyse van 17 studies (5022 patiënten) toont aan dat SGLT2-remmers de ECG-markers van ventriculaire repolarisatieverspreiding significant verlagen, waaronder QTc (MD -4,9 ms) en Tp-e (MD -6,12 ms). Deze electrofysiologische verbeteringen waren na 6 maanden het meest uitgesproken en traden op zonder veranderingen in hartslag of geleidingstijden. De bevindingen bieden mechanistisch inzicht in het verminderde risico op plotselinge hartdood en ventriculaire aritmieën onder SGLT2-remmers, wat de bredere cardioprotectieve rol van deze middelen in de hartfalen- en cardiometabole zorg verder onderstreept.","abstract_original":"BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce sudden cardiac death and ventricular arrhythmias in cardiovascular outcome trials, but the electrophysiological mechanism remains unclear. Surface electrocardiographic (ECG) markers of repolarization dispersion may reflect myocardial electrical stability and provide mechanistic insight. AIM: To assess the impact of SGLT2 inhibitors on electrocardiographic markers of ventricular repolarization dispersion and conduction, and to evaluate whether these changes are consistent with improved ventricular electrical stability. METHODS: We conducted a systematic review and meta-analysis of studies reporting ECG parameters before and after SGLT2 inhibitors and studies comparing SGLT2 inhibitors with other treatments. Searches were performed from database inception through June 2025 across Scopus, Web of Science, PubMed, Scilit, and Google Scholar. Random-effects inverse-variance models using restricted maximum likelihood with Hartung-Knapp adjustment were applied. Prespecified subgroup analyses were performed by follow-up duration. RESULTS: Seventeen studies involving 5022 patients were included. In pre-post analyses, SGLT2 inhibitors significantly reduced QTc (MD -4.9 ms), Tp-e (MD -6.12 ms), P dispersion (MD -3.28 ms), and QTc dispersion (MD -1.36 ms), while R-R interval, PR interval, and QRS duration remained unchanged. Improvements in Tp-e-related indices and QRS-T angle were more pronounced at 6 months. In two-arm comparisons, SGLT2 inhibitors significantly shortened QT interval, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc compared with controls. CONCLUSION: SGLT2 inhibitors reduce ECG markers of ventricular repolarization dispersion without affecting heart rate or conduction intervals, indicating improved ventricular electrical homogeneity."}