THE CARDIOPROTECTIVE EFFECTS OF EMPAGLIFLOZIN IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION AND TYPE 2 DIABETES MELLITUS

Abstract

Introduction. Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome associated with significant morbidity and mortality. Type 2 diabetes mellitus (T2DM) often coexists in patients with HFpEF, further exacerbating the cardiovascular risk. Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, has shown promising results in improving cardiovascular outcomes in patients with T2DM. However, the specific cardioprotective effects of empagliflozin in patients with HFpEF and T2DM remain to be elucidated.
 Aim. To assess the effect of empagliflozin on biochemical markers of heart failure in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction.
 Materials and Methods. The study included 80 patients with HFpEF and T2DM, with 40 patients in the empagliflozin group and 40 patients in the control group. Baseline characteristics, including age, gender, blood pressure, body mass index, and cardiac markers (HbA1c, NT-proBNP, Galectin-3, and sST2), were assessed. Changes in glycemic control and cardiac markers were analyzed after the treatment period.
 Results. Baseline characteristics showed no significant differences between the two groups, indicating successful randomization. Post-treatment analysis revealed a numerical trend towards improved glycemic control in the empagliflozin group compared to the control group. Notably, empagliflozin treatment led to a significant reduction in NT-proBNP levels, indicating improved cardiac function and reduced cardiac stress. Furthermore, empagliflozin was associated with lower Galectin-3 and sST2 levels, suggesting potential benefits in mitigating cardiac fibrosis, remodeling, and inflammation.
 Conclusions. Empagliflozin treatment in patients with HFpEF and T2DM have multifaceted implications beyond glycemic control. The observed reductions in NT-proBNP, Galectin-3, and sST2 levels suggest potential improvements in cardiac function, fibrosis, remodeling, and inflammatory processes. These findings highlight the potential of empagliflozin as a therapeutic option for managing HFpEF and T2DM, offering the potential for comprehensive cardiovascular benefits in this patient population.