Abstract 11436: Empagliflozin Early Reverses Metabolic and Cardiovascular Overload in Type-2 Diabetics With Chronic Heart Failure
Introduction: Diabetes mellitus is thought to be highly involved in complex metabolic and cardiovascular disturbances, however the effective therapies in patients with diabetes mellitus and chronic heart failure have not been established.
Hypothesis: We assessed hypothesis that empagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, a recently developed antidiabetic agent, promptly reverses complex metabolic and cardiac disturbances in patients with type-2 diabetes mellitus and chronic heart failure.
Methods: Type-2 diabetic patients with chronic heart failure were randomized to group-E where they received antidiabetic therapy with empagliflozin for 2 weeks, or to group-C where they received enhanced therapies with conventional antidiabetic agents without an SGLT2 inhibitor. We evaluated practical metabolic and cardiovascular variables including NT-proBNP and ultrasonic quantified diameter of inferior vena cava (IVCD). Changes in practical metabolic and cardiovascular variables were compared between the 2 groups.
Results: The patients in group-E (n=22) manifested improvements in metabolic and cardiovascular variables represented by blood glucose (-35.3±18.2 mg/dL, p=0.02), systolic blood pressure (-7.4±1.5 mmHg, p=0.01), body weight (-1.5±0.7 kg, p=0.01), and NT-proBNP (pg/mL; from 636.3±612.8 to 433.4±437.7, p=0.03), while those in group-C (n=11) showed no improvement except for blood glucose. Heart rate remained unchanged in both groups. The changes in body weight was characterized by those in water weight as well as those in fat weight, but not by those in muscle weight. Respiratory variation in IVCD increased in group-E (%; from 50.4±7.1 to 64.2±8.8, p=0.03), while it remained unchanged in group-C. Changes of respiratory variation in IVCD or NT-proBNP in group-E did not correlate to those of blood glucose (IVCD: r=0.09, p=0.88, NT-proBNP: r=0.14, p=0.68).
Conclusions: These results indicate that empagliflozin in diabetic patients with chronic heart failure early reverses metabolic and cardiovascular overload independent of glucose lowering, which may provide novel potential benefit for management of progressive metabolic and cardiovascular disturbances in type-2 diabetics with chronic heart failure.
Author Disclosures: T. Murakami: None. K. Ohsato: None.
- © 2016 by American Heart Association, Inc.