{"id":"b333d9587d37","type":"article","url":"https://hartvaat.nl/2020/12/08/empagliflozine-en-hemodynamiek-bij-hfref/","title":"Empagliflozine en hemodynamiek bij HFrEF","title_en":"Effect of Empagliflozin on Hemodynamics in Patients With Heart Failure and Reduced Ejection Fraction.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","answer-hf","bloeddrukbehandeling","canagliflozine","dapa-hf","dapagliflozine","empagliflozine","emperor-trials","endotheel","hfpef","hfref","step-hfpef"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2020.10.005","source_url":"https://doi.org/10.1016/j.jacc.2020.10.005","authors":["Massar Omar","Jesper Jensen","Peter H Frederiksen","Caroline Kistorp","Lars Videbæk","Mikael Kjær Poulsen","Sören Möller","Mulham Ali","Finn Gustafsson","Lars Køber","Barry A Borlaug","Morten Schou","Jacob Eifer Møller"],"significance":7,"published":"2020-12-08","source_date":"2020-12-08","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/"],"congress":"","summary_en":"This study characterized the hemodynamic effects of empagliflozin in HFrEF, showing reductions in cardiac preload and afterload markers, providing mechanistic insight into how SGLT2 inhibitors improve heart failure outcomes.","created":"2026-07-03T10:28:57Z","updated":"2026-07-03T18:38:49Z","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":"Studie naar de hemodynamische effecten van empagliflozine bij HFrEF. Mechanistisch inzicht in de SGLT2-remmer werking bij hartfalen.","abstract_original":"BACKGROUND: Inhibition of the sodium-glucose cotransporter-2 (SGLT2i) improves outcomes in patients with heart failure (HF) and reduced ejection fraction (HFrEF), but the mechanism by which they improve outcomes remains unclear. OBJECTIVES: This study aimed to investigate the effects of sodium-glucose cotransporter-2 inhibitor empagliflozin on central hemodynamics in patients with HF and HFrEF. METHODS: This investigator-initiated, double-blinded, placebo-controlled, randomized trial enrolled 70 patients with HFrEF from March 6, 2018, to September 10, 2019. Patients were assigned to empagliflozin of 10 mg or matching placebo once daily on guideline-driven HF therapy for 12 weeks. The primary outcome was ratio of pulmonary capillary wedge pressure (PCWP) to cardiac index (CI) at peak exercise after 12 weeks. Patients underwent right-heart catheterization at rest and during exercise at baseline and 12-week follow-up. RESULTS: Patients with HFrEF, mean age of 57 years, mean left-ventricular ejection fraction, 26%, and 12 (17%) with type 2 diabetes mellitus were randomized. There was no significant treatment effect on peak PCWP/CI (-0.13 mm Hg/l/min/m2; 95% confidence interval: -1.60 to 1.34 mm Hg/l/min/m2; p = 0.86). Considering hemodynamics over the full range of exercise loads, PCWP was significantly reduced (-2.40 mm Hg; 95% confidence interval: -3.96 to -0.84 mm Hg; p = 0.003), but not CI (-0.09 l/min/m2; 95% confidence interval: -0.14 to 0.32 l/min/m2; p = 0.448) by empagliflozin. This was consistent among patients with and without type 2 diabetes. CONCLUSIONS: Among patients with stable HFrEF, empagliflozin for 12 weeks reduced PCWP compared with placebo. There was no significant improvement in neither CI nor PCWP/CI at rest or exercise."}