{"id":"acd6424e1608","type":"article","url":"https://hartvaat.nl/2019/11/19/empagliflozine-en-lv-massa-bij-diabetes-type-2-met-coronairlijden-empa-heart/","title":"Empagliflozine en LV-massa bij diabetes type 2 met coronairlijden: EMPA-HEART","title_en":"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.","category":"preventie","category_label":"Preventie","professions":["cardioloog","internist"],"tags":["answer-hf","dapa-hf","diabetes-en-hart","diabetes-type-2","empagliflozine","emperor-trials","figaro-dkd","obesitas","slaapapneu","soul-trial"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.119.042375","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.119.042375","authors":["Subodh Verma","C David Mazer","Andrew T Yan","Tamique Mason","Vinay Garg","Hwee Teoh","Fei Zuo","Adrian Quan","Michael E Farkouh","David H Fitchett","Shaun G Goodman","Ronald M Goldenberg","Mohammed Al-Omran","Richard E Gilbert","Deepak L Bhatt","Lawrence A Leiter","Peter Jüni","Bernard Zinman","Kim A Connelly"],"significance":8,"published":"2019-11-19","source_date":"2019-11-19","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/preventie/preventie-bij-diabetes/"],"congress":"","summary_en":"The EMPA-HEART trial demonstrated that empagliflozin significantly reduced left ventricular mass index in patients with type 2 diabetes and coronary artery disease, providing the first randomized evidence of direct structural cardiac effects from SGLT2 inhibition.","created":"2026-07-03T10:28:16Z","updated":"2026-07-03T13:27:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"EMPA-HEART trial die aantoonde dat empagliflozine de linkerkamermassa vermindert bij diabetespatiënten met coronairlijden. Structureel cardioprotectief effect.","abstract_original":"BACKGROUND: SGLT2 (sodium-glucose cotransporter 2) inhibitors lower cardiovascular events in type 2 diabetes mellitus but whether they promote direct cardiac effects remains unknown. We sought to determine if empagliflozin causes a decrease in left ventricular (LV) mass in people with type 2 diabetes mellitus and coronary artery disease. METHODS: Between November 2016 and April 2018, we recruited 97 individuals ≥40 and ≤80 years old with glycated hemoglobin 6.5% to 10.0%, known coronary artery disease, and estimated glomerular filtration rate ≥60mL/min/1.73m2. The participants were randomized to empagliflozin (10 mg/day, n=49) or placebo (n=48) for 6 months, in addition to standard of care. The primary outcome was the 6-month change in LV mass indexed to body surface area from baseline as measured by cardiac magnetic resonance imaging. Other measures included 6-month changes in LV end-diastolic and -systolic volumes indexed to body surface area, ejection fraction, 24-hour ambulatory blood pressure, hematocrit, and NT-proBNP (N-terminal pro b-type natriuretic peptide). RESULTS: Among the 97 participants (90 men [93%], mean [standard deviation] age 62.8 [9.0] years, type 2 diabetes mellitus duration 11.0 [8.2] years, estimated glomerular filtration rate 88.4 [16.9] mL/min/1.73m2, LV mass indexed to body surface area 60.7 [11.9] g/m2), 90 had evaluable imaging at follow-up. Mean LV mass indexed to body surface area regression over 6 months was 2.6 g/m2 and 0.01 g/m2 for those assigned empagliflozin and placebo, respectively (adjusted difference -3.35 g/m2; 95% CI, -5.9 to -0.81g/m2, P=0.01). In the empagliflozin-allocated group, there was significant lowering of overall ambulatory systolic blood pressure (adjusted difference -6.8mmHg, 95% CI -11.2 to -2.3mmHg, P=0.003), diastolic blood pressure (adjusted difference -3.2mmHg; 95% CI, -5.8 to -0.6mmHg, P=0.02) and elevation of hematocrit (P=0.0003). CONCLUSIONS: Among people with type 2 diabetes mellitus and coronary artery disease, SGLT2 inhibition with empagliflozin was associated with significant reduction in LV mass indexed to body surface area after 6 months, which may account in part for the beneficial cardiovascular outcomes observed in the EMPA-REG OUTCOME (BI 10773 [Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) trial. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02998970."}