Effects of empagliflozin on exercise tolerance and left ventricular diastolic function in patients with heart failure with preserved ejection fraction and type 2 diabetes: a prospective single-center study

Effects of empagliflozin on exercise tolerance and left ventricular diastolic function in patients with heart failure with preserved ejection fraction and type 2 diabetes: a prospective single-center study

Aim. To assess the effect of the sodium-glucose transport protein 2 inhibitor empagliflozin on exercise tolerance and left ventricular (LV) diastolic function in patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes (T2D).Material and methods. The present prospecti...

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Published in:Rossiĭskiĭ kardiologicheskiĭ zhurnal Vol. 26; no. 1; p. 4304
Main Authors: Ovchinnikov, A. G., Borisov, A. A., Zherebchikova, K. Yu, Ryabtseva, O. Yu, Gvozdeva, A. D., Masenko, V. P., Ageev, F. T., Boytsov, S. A.
Format: Journal Article
Language:English
Russian
Published: FIRMA «SILICEA» LLC 17-02-2021
Subjects:
diabetes
diastolic dysfunction
diastolic stress test
empagliflozin
filling pressure
heart failure with preserved ejection fraction
left ventricle
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Summary:Aim. To assess the effect of the sodium-glucose transport protein 2 inhibitor empagliflozin on exercise tolerance and left ventricular (LV) diastolic function in patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes (T2D).Material and methods. The present prospective, single-center, open-label study included 60 patients with HFpEF and T2D, who were assigned to groups receiving empagliflozin 10 mg/day. or previously taken hypoglycemic therapy (control group). The follow-up period lasted 24 weeks. All patients underwent a 6-minute walk test and rest and stress echocardiography at baseline and at the end of the study.Results. After 24 weeks. in the empagliflozin group there was an increase in the 6-minute walk test distance by 20 m (95% confidence interval (CI), from 7 to 33 m), a decrease in the early mitral inflow to mitral annulus relaxation velocities (E/e’) ratio by 1,8 (95% CI, from -2,4 to -1,2) and maximum left atrial volume by 2,6 (95% CI, from -4,4 to -0,8) ml/m2, as well as an increase in the diastolic reserve (mitral annulus relaxation velocity increment e’ during exercise increased from 2,2 (95% CI, 1,7 to 2,7) to 3,4 (95% CI, 2,4 to 4,2) cm/s; P<0,01 for all). There were no significant changes in the control group.Conclusion. In patients with HFpEF and T2D, empagliflozin improves exercise tolerance and LV diastolic function. Large-scale placebo-controlled randomized trials are required to prove these findings.
ISSN:1560-4071
2618-7620
DOI:10.15829/1560-4071-2021-4304