Clues to How SGLT2 Inhibitors Work: CAMEO-DAPA

Recorded 3/31/2023 This transcript has been edited for clarity.

Ileana L. Piña, MD, MPH: Hi, everyone. I'm Ileana Piña from Thomas Jefferson University, and this is my blog.

I have with me today Barry Borlaug, who is from Mayo Clinic in Rochester. He is well known for his description of the exercise hemodynamics of patients with heart failure with preserved ejection fraction (HFpEF). It's a diagnosis that some of my colleagues wrestle with because the patient may show up with hypertension; they may show up with diabetes; or they may show up simply because they can't breathe, they're obese, and they're not walking very well. These are primarily women, usually older women, who have many comorbidities.

Now, we have the sodium-glucose cotransporter 2 (SGLT2) inhibitors in the guidelines for this group of patients with HFpEF, which, by our new definition today, is an ejection fraction above or equal to 50%. I think this fits with what Dr Eugene Braunwald has been saying for a long time: That's the real HFpEF.

Probably one of the best diagnostic things that we can do for these patients is to figure out what their left atrial pressures are with activity. That may distinguish them from other things.