Related Experiment Video
Updated: Aug 26, 2025
07:09
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
Published on: February 18, 2022
2.0K
SGLT2 Inhibitors and Heart Failure with Preserved Ejection Fraction
1British Heart Foundation Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, United Kingdom.
Heart Failure Clinics
|October 10, 2022
Summary
Sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrated significant benefits in patients with heart failure with preserved ejection fraction (HFPEF). Empagliflozin reduced cardiovascular death or hospitalization, establishing SGLT2 inhibitors as a new standard of care.
Area of Science:
- Cardiology
- Pharmacology
- Endocrinology
Background:
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for type 2 diabetes, showed promise in heart failure (HF) patients.
- Prior trials confirmed SGLT2 inhibitor efficacy in heart failure with reduced ejection fraction (HFrEF).
Purpose of the Study:
- To evaluate the efficacy of SGLT2 inhibitors in patients with heart failure with preserved ejection fraction (HFPEF).
Main Methods:
- The EMPEROR-Preserved trial randomized patients with HFPEF to receive the SGLT2 inhibitor empagliflozin or placebo.
- The primary endpoint was the composite of cardiovascular death or hospitalization for heart failure.
Main Results:
- Empagliflozin significantly reduced the risk of cardiovascular death or heart failure hospitalization (HR 0.79; P < .001).
- This benefit was primarily driven by a reduction in worsening heart failure events.
Conclusions:
- SGLT2 inhibitors, exemplified by empagliflozin, represent a significant advancement in HFPEF treatment.
- These findings suggest SGLT2 inhibitors are poised to become a new standard of care for HFPEF management.
Related Concept Videos
01:30Heart Failure V: Medical Management
19
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
19
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
488
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
488
01:22Heart Failure Drugs: Diuretics
457
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
457
01:26Heart Failure Drugs: Inotropic Agents
688
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
688
01:22Heart Failure Drugs: β-Blockers
418
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
418
01:22Heart Failure VI: Adjunct Therapies
25
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
25