Early effects of empagliflozin on exercise tolerance in patients with heart failure: A pilot study.

Abstract

Background: Sodium-glucose linked transporter 2 inhibition recently emerged as a promising ther- apy for reducing the risk of heart failure (HF) in patients with type 2 diabetes mellitus (T2DM). However, there is a lack of data endorsing its role in symptomatic HF patients. We sought to eval- uate the short-term effects of empagliflozin on maximal exercise capacity in these patients. Hypothesis: We postulate tretament with empagliflozin may improve functional capacity in patients with T2DM and established HF. Methods: Nineteen T2DM patients with symptomatic HF were prospectively included and underwent cardiopulmonary exercise testing before and 30 days after initiation of empagliflo- zin therapy. A mixed-effects model for repeated measures was used. Results: Median patient age was 72 years (interquartile range, 60–79 years); 42.1% were in New York Heart Association class III. Baseline mean ( SD) peak oxygen consum ption (peak VO 2 ) was 10.9  4. 0 mL/ min /k g. P eak VO 2 increased significantly at 30 days (∆: +1.21 [0.66 to 1.76] mL/min/kg; P < 0.001). A significant improvement in ventilatory efficiency during exercise, 6-minute walking distance, and quality of life, and a reduction in antigen carbohydrate 125, were also found. Estimated glomerular filtration rate and natriuretic peptides did not significantly change. Conclusions: In this pilot study, empagliflozin was associated with 1-month improvement in exercise capacity in T2DM patients with symptomatic HF. This beneficial effect was also found for other surrogates of severity.