Effects of empagliflozin on right ventricular adaptation to pressure overload

Figures

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  Figure 1. Study design. Male Wistar rat weanlings were randomized to sham or pulmonary trunk banding (PTB) surgery. One week after the surgery, a baseline echocardiography was performed, and treatment was initiated. Five weeks after the PTB surgery, cardiac function was evaluated by clinically relevant methods including echocardiography, MRI, and invasive pressure-volume measurements. The rats were euthanized, and histochemical analyses were performed on the heart.

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  Figure 2. Pulmonary trunk banding and empagliflozin's effect on right ventricular systolic dysfunction at end-of-study. PTB: pulmonary trunk banding, empa: empagliflozin. (A) Arterial elastance. (B) Right ventricular (RV) end-systolic pressure. (C) Cardiac output. (D) Tricuspid annular plane systolic excursion (TAPSE). (E) First derivative (maximal) of right ventricular systolic pressure. One PTB-control excluded. (F) End-systolic elastance. (G) Ventricular-arterial coupling. Results are expressed as scatterplots with mean ± SEM. *p < 0.05; **p < 0.01; ***p < 0.001; ****p < 0.0001 PTB-control vs. sham. ^p < 0.05 PTB-empa vs. PTB-control.

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  Figure 3. Effects of pulmonary trunk banding and empagliflozin on RV and RA dilatation and hypertrophy. PTB: pulmonary trunk banding, empa: empagliflozin. (A) RV end-systolic (red markings) and end-diastolic volume (white markings). (B) Fulton index (right ventricle (RV)/left ventricle (LV) and septum (S). (C) RV cross sectional area (CSA). Histological RV sections stained with hematoxylin & eosin from (D) Sham, (E) PTB-control, and (F) PTB-empa, black scale bar equals 50 µm. (G) RA end-systolic (red markings) and end-diastolic volume (white markings). (H) Right atrial (RA) weight. (I) RA cross sectional area (CSA), data from one sham animal is missing. Results are expressed as scatterplots with mean ± SEM. **p < 0.01; ***p < 0.001 PTB-control vs. sham. ^^p < 0.01 PTB-empa vs. PTB-control.

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  Figure 4. Effects of pulmonary trunk banding and empagliflozin on RV diastolic dysfunction at end-of-study. PTB: pulmonary trunk banding, empa: empagliflozin. (A) Right ventricular (RV) filling pressure as (end-diastolic pressure)–(beginning of diastolic pressure). (B) RV filling pressure as tricuspid valve E/e’. Two PTB-empa are missing due to EA fusion. (C) RV end-diastolic elastance. (D) First derivative (minimal) of RV systolic pressure. (E) The relaxation time constant, Tau logistic. (F) Ratio of trans tricuspid valve flow velocities. Two PTB-empa rats missing due to EA fusion. Results are expressed as scatterplots with mean ± SEM. **p < 0.01; ****p < 0.0001 PTB-control vs. sham. ^p < 0.05; ^^^p < 0.001 PTB-empa vs. PTB-control.