Comparative Effects of Empagliflozin and Semaglutide on Left Ventricular Diastolic Function in HFpEF Patients with Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials
Abstract
This systematic review evaluates the comparative effects of Empagliflozin and Semaglutide on left ventricular diastolic function in patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM). A comprehensive search was conducted in accordance with PRISMA guidelines, including randomized controlled trials published within the last five years. Eight clinical trials met the inclusion criteria, focusing on primary outcomes such as changes in echocardiographic parameters, including the E/e’ ratio and left atrial volume index, alongside secondary outcomes like NT-proBNP levels, functional capacity, hospitalization rates, and cardiovascular mortality. Semaglutide demonstrated superior improvements in diastolic function, significantly reducing left atrial volume, E/e’ ratio, and right ventricular dimensions, suggesting its potential as a disease-modifying therapy in HFpEF. Empagliflozin showed marked improvements in left ventricular filling pressures but limited effects on structural remodeling. Both agents positively impacted secondary outcomes, including NT-proBNP reduction and functional status, although Semaglutide exhibited greater reductions in inflammatory markers and body weight. The findings underscore the importance of individualized treatment strategies based on patient-specific factors, including comorbidities, tolerability, and clinical presentation. While Semaglutide appears more effective in reversing diastolic…
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