Impact of Empagliflozin Versus Dapagliflozin on Left Ventricular Remodeling in Heart Failure Patients: A 1-Year Comparative Study
Abstract
BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) reduce cardiovascular mortality and heart failure (HF)-related hospitalizations in HF patients. However, the mechanisms underlying these benefits remain unclear, and it is uncertain whether empagliflozin and dapagliflozin have differential effects on cardiac structure and function.
AIM: This study aims to compare the effects of these two SGLT2is on left ventricular echocardiographic parameters in HF patients over 1 year.
METHODS: This retrospective study included 558 consecutive HF patients newly prescribed either dapagliflozin or empagliflozin. Key echocardiographic parameters, such as peak E-wave velocity, E/e' ratio, left atrial volume index (LAVI), LV end-diastolic and end-systolic volumes (LV-EDVI, LV-ESVI), LV mass index (LV-MI), relative wall thickness (RWT), LV sphericity index (LV-SI), and ejection fraction (LVEF), were measured at baseline and after 1 year.
RESULTS: At 1-year, significant reductions were observed only in the empagliflozin group for peak E-wave velocity (mean difference = -12.76 cm/s, 95% CI: -16.26 to -9.27, p < 0.001), E/e' ratio (mean difference = -3.04, 95% CI: -4.17 to -1.91, p < 0.001), and LV sphericity index (LV-SI; mean difference = -0.01, 95% CI: -0.02 to -0.0005, p = 0.040). Both SGLT2is significantly improved E-wave deceleration time, LAVI, LV-EDVI, LV-ESVI, LV-MI, and LVEF. Neither medication produced significant changes in RWT, and no significant differences were noted…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 558 participants or records.
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