Effects of early empagliflozin in acute decompensated HFrEF on ventricular systolic and diastolic parameters: interaction with endothelial function and arterial stiffness
Abstract
Heart failure with reduced ejection fraction (HFrEF) is associated with endothelial dysfunction, arterial stiffness, and impaired ventricular function, contributing to poor outcomes. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), such as empagliflozin, have demonstrated cardioprotective effects beyond glucose control, including potential benefits on vascular and myocardial function. However, their short-term impact in acute decompensated HF remains insufficiently explored.
This study aimed to evaluate the short-term effects of empagliflozin on endothelial function, arterial stiffness, and indices of systolic and diastolic left ventricular (LV) function in patients hospitalized with acute or de novo HFrEF, independent of diabetes status.
Thirty-four patients with acute or newly diagnosed HFrEF were prospectively enrolled and randomized to receive either standard guideline-directed medical therapy (GDMT) alone (n=14) or with empagliflozin 10 mg daily (n=20) initiated within 24–72 hours of admission. GDMT included ACE inhibitors/ARNI, beta-blockers, mineralocorticoid receptor antagonists, and diuretics. Echocardiographic measures (LV ejection fraction (LVEF), LV global longitudinal strain (LV-GLS), E/e’, left atrial (LA) strain), endothelial function (flow-mediated dilation (FMD)), and arterial stiffness parameters (pulse wave velocity (PWV), augmentation index (Aix)) were assessed at baseline, one month, and two months.
Baseline clinical characteristics and imaging…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 20 participants or records.
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