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Impact of empagliflozin on right ventricular parameters and function among patients with type 2 diabetes

Bradley Sarak1,2, Subodh Verma2,3,4, C David Mazer2,5

  • 1Division of Cardiology, Terrence Donnelly Heart Centre, St Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.

Cardiovascular Diabetology
|October 5, 2021
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibition with empagliflozin did not alter right ventricular remodeling in patients with type 2 diabetes and coronary artery disease. Further research is needed to explore potential differential effects on the left and right ventricles.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular events in type 2 diabetes (T2DM).
  • SGLT2 inhibition is linked to reduced left ventricular (LV) mass, but its effect on right ventricular (RV) remodeling is unknown.
  • This study investigated the impact of SGLT2 inhibition on RV parameters in T2DM patients with coronary artery disease (CAD).

Purpose of the Study:

  • To assess the effect of SGLT2 inhibition on right ventricular (RV) mass index (RVMi), RV volumes, and RV ejection fraction (RVEF).
  • To evaluate RV remodeling in patients with type 2 diabetes (T2DM) and coronary artery disease (CAD) treated with empagliflozin.
  • To determine if SGLT2 inhibition influences RV structure and function in this patient population.

Main Methods:

  • A post-hoc analysis of the EMPA-HEART CardioLink-6 trial involving 97 patients with T2DM and CAD.
  • Patients were randomized to receive empagliflozin (10 mg daily) or placebo.
  • Cardiac magnetic resonance imaging (CMR) was performed at baseline and 6 months to assess RV mass index (RVMi), RV end-diastolic and end-systolic volume index (RVEDVi, RVESVi), and RV ejection fraction (RVEF).

Main Results:

  • Baseline RV parameters (RVMi, RVEF, RVEDVi, RVESVi) were within normal limits and similar between groups.
  • Over 6 months, empagliflozin showed no significant differences compared to placebo in RVMi, RVEF, RVEDVi, or RVESVi.
  • No significant correlation was observed between changes in RVMi and LV mass index (LVMi) in either group.

Conclusions:

  • SGLT2 inhibition with empagliflozin did not impact RV mass index or RV volumes in patients with T2DM and CAD.
  • The findings suggest that SGLT2 inhibitors may not influence RV remodeling in this specific patient cohort.
  • Further investigation is warranted to explore potential differential effects of empagliflozin on the LV and RV.
Keywords:
Right ventricleSodium-glucose transporter 2 inhibitionType 2 diabetes

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