Letter by Tsuda Regarding Article, "Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The EMPA-HEART CardioLink-6 Randomized Clinical Trial".
Abstract
Circulation. 2020;141:e100–e101. DOI: 10.1161/CIRCULATIONAHA.119.044977 e100 Kazushi Tsuda , MD To the Editor: I read with great interest the article by Dr Verma and colleagues1 dealing with the relationship between sodium-glucose cotransporter 2 (SGLT2) inhibitors and cardiac hypertrophy. The results of their study demonstrated that the SGLT2 inhibitor empagliflozin significantly reduced left ventricular mass indexed to body surface area (LVMi) measured by cardiac magnetic resonance imaging in subjects with type 2 diabetes mellitus and coronary artery disease in the EMPA-HEART CardioLink-6 randomized clinical trial (BI 10773 [Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients). The use of empagliflozin was also associated with a significant lowering of ambulatory systolic blood pressure with no impact on the circulating levels of NT-proBNP (N-terminal pro B-type natriuretic peptide). In addition, further exploratory analyses suggested that the reduction in LVMi might be independent of blood pressure changes. The authors have proposed that SGLT2 inhibition with empagliflozin leads to a significant reduction in LVMi, which may contribute to the beneficial cardiovascular outcomes in patients with type 2 diabetes mellitus and coronary artery disease. Evidence indicates that nitric oxide (NO) might actively participate in the regulation of cardiac hypertrophy. Yeboah et al2 showed that LVMi assessed with magnetic resonance imaging might be…
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