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2017 ; 2
(4
): 347-354
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Empagliflozin Prevents Worsening of Cardiac Function in an Experimental Model of
Pressure Overload-Induced Heart Failure
#MMPMID30062155
Byrne NJ
; Parajuli N
; Levasseur JL
; Boisvenue J
; Beker DL
; Masson G
; Fedak PWM
; Verma S
; Dyck JRB
JACC Basic Transl Sci
2017[Aug]; 2
(4
): 347-354
PMID30062155
show ga
This study sought to determine whether the sodium/glucose cotransporter 2 (SGLT2)
inhibitor empagliflozin improved heart failure (HF) outcomes in nondiabetic mice.
The EMPA-REG OUTCOME (Empagliflozin, Cardiovascular Outcome Event Trial in Type 2
Diabetes Mellitus Patients) trial demonstrated that empagliflozin markedly
prevented HF and cardiovascular death in subjects with diabetes. However, despite
ongoing clinical trials in HF patients without type 2 diabetes, there are no
objective and translational data to support an effect of SGLT2 inhibitors on
cardiac structure and function, particularly in the absence of diabetes and in
the setting of established HF. Male C57Bl/6 mice were subjected to either sham or
transverse aortic constriction surgery to induce HF. Following surgery, mice that
progressed to HF received either vehicle or empagliflozin for 2 weeks. Cardiac
function was then assessed in vivo using echocardiography and ex vivo using
isolated working hearts. Although vehicle-treated HF mice experienced a
progressive worsening of cardiac function over the 2-week treatment period, this
decline was blunted in empagliflozin-treated HF mice. Treatment allocation to
empagliflozin resulted in an improvement in cardiac systolic function, with no
significant changes in cardiac remodeling or diastolic dysfunction. Moreover,
isolated hearts from HF mice treated with empagliflozin displayed significantly
improved ex vivo cardiac function compared to those in vehicle-treated controls.
Empagliflozin treatment of nondiabetic mice with established HF blunts the
decline in cardiac function both in vivo and ex vivo, independent of diabetes.
These data provide important basic and translational clues to support the
evaluation of SGLT2 inhibitors as a treatment strategy in a broad range of
patients with established HF.