Associations of Empagliflozin With Left Ventricular Volumes, Mass, and Function in Patients With Heart Failure and Reduced Ejection Fraction A Substudy of the Empire HF Randomized Clinical Trial

The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in improving the outcomes associated with heart failure and a reduced ejection fraction (HFrEF) is well established. On the other hand, an association of SGLT2i with cardiac remodeling has not been investigated. Hence, Massar Omar and colleagues conducted a study under the title “Associations of Empagliflozin With Left Ventricular Volumes, Mass, and Function in Patients With Heart Failure and Reduced Ejection Fraction A Substudy of the Empire HF Randomized Clinical Trial” published in JAMA Cardiology. The summary of this research is given below:

Objective:

To examine the outcome of the SGLT2i empagliflozin on cardiac remodeling in patients with HFrEF.

Method:

This is an investigator-initiated, multicenter, double-blind, placebo-controlled randomized clinical trial conducted in Denmark. Participants with stable HFrEF and ejection fractions of 40% or less were included. Enrollment was initiated on June 29, 2017, and continued through September 10, 2019.
Primary outcome measures were changes from baseline to week 12 in left atrial volume index, left ventricular end-systolic and end-diastolic volume indexes, and left ventricular ejection fraction adjusted for age, sex, type 2 diabetes, and atrial fibrillation. Secondary outcome measures included changes in global longitudinal strain, left ventricular mass index, and relative wall thickness.

Findings:

This echocardiographic substudy indicated a positive association of empagliflozin in providing a modest reduction in cardiac volumes in patients with HFrEF after 12 weeks of treatment.
Outcomes beyond 12 weeks of SGLT2i use in patients with HFrEF require further study.

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