Empagliflozin does not improve contractile reserve in heart failure: Data from Empire HF trial

Denmark: The addition of SGLT2 inhibitor empagliflozin to guideline-directed HF therapy for 12 weeks did not improve left ventricular (LV) contractile reserve in patients with heart failure (HF) and reduced ejection fraction, according to results from the prespecified sub-study of the Empire HF trial. The study appears in the American Heart Journal. 

Sodium-glucose co-transporter-2 inhibitors are known to improve cardiac structure but most studies indicate no change in LV systolic function at rest. It is not known whether SGLT2 inhibitors improve LV contractile reserve. Jesper Jensen, Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark, and colleagues, therefore, examined the effect of empagliflozin on LV contractile reserve in patients with heart failure and reduced ejection fraction.

The researchers conducted a Prespecified sub-study of the Empire HF trial -- double-blind, placebo-controlled, and randomized trial. Patients with LV ejection fraction (LVEF) ≤ 40% on guideline-directed HF therapy were included. They were randomized in a ratio of 1:1 to receive empagliflozin 10 mg or placebo for 12 weeks. Low dose dobutamine stress echocardiography was used to assess the treatment effect on contractile reserve.