The effect of empagliflozin on contractile reserve in heart failure: Prespecified sub-study of a randomized, double-blind, and placebo-controlled trial
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The effect of empagliflozin on contractile reserve in heart failure : Prespecified sub-study of a randomized, double-blind, and placebo-controlled trial. / Jensen, Jesper; Omar, Massar; Ali, Mulham; Frederiksen, Peter H.; Kistorp, Caroline; Tuxen, Christian; Andersen, Camilla F.; Larsen, Julie H.; Ersbøll, Mads Kristian; Køber, Lars; Gustafsson, Finn; Faber, Jens; Forman, Julie Lyng; Møller, Jacob Eifer; Schou, Morten.
I: American Heart Journal, Bind 250, 2022, s. 57-65.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The effect of empagliflozin on contractile reserve in heart failure
T2 - Prespecified sub-study of a randomized, double-blind, and placebo-controlled trial
AU - Jensen, Jesper
AU - Omar, Massar
AU - Ali, Mulham
AU - Frederiksen, Peter H.
AU - Kistorp, Caroline
AU - Tuxen, Christian
AU - Andersen, Camilla F.
AU - Larsen, Julie H.
AU - Ersbøll, Mads Kristian
AU - Køber, Lars
AU - Gustafsson, Finn
AU - Faber, Jens
AU - Forman, Julie Lyng
AU - Møller, Jacob Eifer
AU - Schou, Morten
N1 - Publisher Copyright: © 2022 The Author(s)
PY - 2022
Y1 - 2022
N2 - Background: Sodium-glucose co-transporter-2 inhibitors improve cardiac structure but most studies suggest no change in left ventricular (LV) systolic function at rest. Whether sodium-glucose co-transporter-2 inhibitors improve LV contractile reserve is unknown. We investigated the effect of empagliflozin on LV contractile reserve in patients with heart failure (HF) and reduced ejection fraction. Methods: Prespecified sub-study of the Empire HF trial, a double-blind, placebo-controlled, and randomized trial. Patients with LV ejection fraction (LVEF) ≤ 40% on guideline-directed HF therapy were randomized (1:1) to empagliflozin 10 mg or placebo for 12 weeks. The treatment effect on contractile reserve was assessed by low dose dobutamine stress echocardiography. Results: In total, 120 patients were included. The mean age was 68 (SD 10) years, 83% were male, and the mean LVEF was 38 (SD 10) %. Respectively 60 (100%) and 59 (98%) patients in the empagliflozin and placebo groups completed stress echocardiography. No statistically significant effect of empagliflozin was observed for the contractile reserve assessed by LV-GLS (adjusted mean absolute change, empagliflozin vs placebo, 0.7% [95% confidence interval {CI} –0.5 to 2.0, P = .25]) or LVEF (adjusted mean absolute change, empagliflozin vs placebo, 2.2% [95% CI –1.4 to 5.8, P = .22]) from baseline to 12 weeks. LV-GLS contractile reserve was associated with accelerometer-measured daily activity level (coefficient –24 accelerometer counts [95% CI –46 to –1.8, P = .03]). Conclusions: Empagliflozin for 12 weeks added to guideline-directed HF therapy did not improve LV contractile reserve in patients with HF and reduced ejection fraction.
AB - Background: Sodium-glucose co-transporter-2 inhibitors improve cardiac structure but most studies suggest no change in left ventricular (LV) systolic function at rest. Whether sodium-glucose co-transporter-2 inhibitors improve LV contractile reserve is unknown. We investigated the effect of empagliflozin on LV contractile reserve in patients with heart failure (HF) and reduced ejection fraction. Methods: Prespecified sub-study of the Empire HF trial, a double-blind, placebo-controlled, and randomized trial. Patients with LV ejection fraction (LVEF) ≤ 40% on guideline-directed HF therapy were randomized (1:1) to empagliflozin 10 mg or placebo for 12 weeks. The treatment effect on contractile reserve was assessed by low dose dobutamine stress echocardiography. Results: In total, 120 patients were included. The mean age was 68 (SD 10) years, 83% were male, and the mean LVEF was 38 (SD 10) %. Respectively 60 (100%) and 59 (98%) patients in the empagliflozin and placebo groups completed stress echocardiography. No statistically significant effect of empagliflozin was observed for the contractile reserve assessed by LV-GLS (adjusted mean absolute change, empagliflozin vs placebo, 0.7% [95% confidence interval {CI} –0.5 to 2.0, P = .25]) or LVEF (adjusted mean absolute change, empagliflozin vs placebo, 2.2% [95% CI –1.4 to 5.8, P = .22]) from baseline to 12 weeks. LV-GLS contractile reserve was associated with accelerometer-measured daily activity level (coefficient –24 accelerometer counts [95% CI –46 to –1.8, P = .03]). Conclusions: Empagliflozin for 12 weeks added to guideline-directed HF therapy did not improve LV contractile reserve in patients with HF and reduced ejection fraction.
U2 - 10.1016/j.ahj.2022.04.008
DO - 10.1016/j.ahj.2022.04.008
M3 - Journal article
C2 - 35513022
AN - SCOPUS:85131425854
VL - 250
SP - 57
EP - 65
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
ER -
ID: 310434770