Effect of empagliflozin on left ventricular structure and function in patients with heart failure with preserved ejection fraction

The aim – to assess the effects of empagliflozin on myocardial function and left ventricular shape in individuals with heart failure with preserved ejection fraction (HFpEF). Materials and methods. This was a prospective, non-randomized, single-center observational study that involved 106 HFpEF patients. These patients were classified into two groups; while Group I consisted of patients taking empagliflozin 10 mg/day along with optimal medical therapy, Group II comprised patients on optimum medical therapy excluding empagliflozin. The clinical, biochemical, and echocardiographic assessments were conducted at baseline and after six months of follow-up. The echocardiographic evaluation included left ventricular global longitudinal strain (LV-GLS) via two-dimensional speckle tracking echocardiography, left ventricular end-diastolic volume, left ventricular end-systolic volume, and left ventricular ejection fraction assessed through three-dimensional echocardiography, alongside left ventricular mass index (LVMI), left atrial volume index (LAVI), pulmonary artery systolic pressure (PASP), and mitral E/E´ ratio determined by conventional echocardiography.Results. After 6 months of the drug therapy, patients using empagliflozin showed considerable improvement in LV-GLS in comparison to the control group. Within the empagliflozin group, LVMI, LAVI, PASP and mitral E/E´ decreased significantly from baseline. Also, patients on empagliflozin showed a significant improvement in KCCQ-12 score and substantial reduction in NT-proBNP levels.Conclusions. Empagliflozin therapy was associated with a remarkable improvement in LV longitudinal systolic and diastolic function in HFpEF patients, as well as an improvement in health-related quality of life.