Effect of empagliflozin on human primary cardiomyocytes in a chemically induced hypoxia by <scp> CoCl ₂ </scp>

Cardiovascular diseases (CVD) are the leading cause of premature death and disability. Hypoxic conditions play a central role in the pathophysiology of all CVD. Empagliflozin (EMPA), a sodium-glucose cotransporter 2 (SGLT2) inhibitor used for diabetes mellitus type II therapy, has demonstrated a beneficial role in improving cardiovascular outcomes for patients with heart failure. Our study aimed to assess the cardioprotective effect of EMPA on primary human cardiomyocytes in a chemically induced hypoxia model. The cardioprotective effect of the SGLT2 inhibitor was evaluated through four individual experiments including: (1) evaluating mitochondrial network integrity, (2) determining cell count, (3) metabolomic profiling, and (4) determining alterations in miRNA expression. After 24 h of EMPA treatment, we observed a significant improvement in mitochondrial network complexity, as evidenced by increased branching (p < 0.05) and a reduced number of rod-shaped mitochondria (p < 0.05) in EMPA-treated cells compared to controls. After cobalt treatment, we didn't observe any protective effect of EMPA in cells affected by cobalt in various biological aspects, including miRNA expression, metabolomics, or viability. Although EMPA treatment was not able to propagate beneficial effects in the presence of cobalt, pretreatment of cells with EMPA indicated a potential cardioprotective effect associated with improving mitochondrial morphology.