Empagliflozin 25 mg/day added to standard therapy significantly decreased left atrial volume compared to placebo in patients with acute decompensated heart failure (mean decrease 30.9 vs 10.5; P<0.001).
RCT (n=60)
Double-blind
randomized
No
Does empagliflozin improve echocardiographic parameters of load, left ventricular or right ventricular function in patients with acute decompensated heart failure?
Immediate addition of empagliflozin 25 mg/day to standard therapy in acute decompensated heart failure significantly reduces left atrial volume and left atrial end-systolic volume index over 5 days.
Absolute Event Rate: 30.9% vs 10.5%
p-value: p=<0.001
BACKGROUND: Sodium-glucose co-transporter 2 (SGLT2) inhibitors improve prognosis in chronic heart failure as part of currently recommended therapeutic strategies. Transthoracic echocardiography (TTE) is frequently used to assess heart function and dimensions in acute heart failure to lead therapy and assess volume status. Immediate changes, especially of left heart haemodynamic parameters, measured by echocardiography in patients with acute heart failure treated with SGLT2 inhibitors, remain unknown. AIM: The aim of this pre-defined secondary analysis was to assess whether treatment with empagliflozin 25 mg/day in patients with acute heart failure improves echocardiographic parameters of load, left ventricular or right ventricular function. METHODS AND RESULTS: In the single-centre, prospective, double-blind, placebo-controlled EMPAG-HF trial, patients with acute decompensated heart failure (ADHF) were screened and randomized within 12 h following hospital admission to receive either empagliflozin or placebo in addition to standard medical treatment over 5 days. Sixty patients were enrolled and randomized irrespective of left ventricular ejection fraction or diabetes. All patients received 2D TTE on admission (tB = at baseline) and after completing the study treatment (tC = time after completing study medication) (according to study design). The recorded loops were analysed using dedicated software (Image-Arena™ Version 4.6; TomTec Imaging Systems). After 5 days of treatment, patients in the empagliflozin cohort showed a relevant decrease in left atrial volume LAV: ∆tB-tC = 30.9 ± 27.4; 95% confidence interval (CI) 20.1-41.7) compared to placebo ∆tB-tC = 10.5 ± 26; 95% CI 0.4-20.5; P = <0.001 and left atrial end-systolic volume index (LAESVI: ∆tB-tC = 15.7 ± 15.1; 95% CI 9.8-21.6 vs. placebo ∆tB-tC = 9.7 ± 10.2; 95% CI 5.7-13.6; P = 0.016) compared to placebo. CONCLUSION: Immediate addition of empagliflozin to standard therapy improves echocardiographic parameters of LAV in patients following recompensation of ADHF.
Bogoviku et al. (Sat,) conducted a rct in acute decompensated heart failure (ADHF) (n=60). empagliflozin vs. placebo was evaluated on decrease in left atrial volume (LAV) (p=<0.001). Empagliflozin 25 mg/day added to standard therapy significantly decreased left atrial volume compared to placebo in patients with acute decompensated heart failure (mean decrease 30.9 vs 10.5; P<0.001).