# Empagliflozine en hemodynamiek bij HFrEF

*geplaatst 2020-12-08 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2020.10.005 · https://hartvaat.nl/2020/12/08/empagliflozine-en-hemodynamiek-bij-hfref/*

Studie naar de hemodynamische effecten van empagliflozine bij HFrEF. Mechanistisch inzicht in de SGLT2-remmer werking bij hartfalen.

## English: Effect of Empagliflozin on Hemodynamics in Patients With Heart Failure and Reduced Ejection Fraction.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2020.10.005. Bijgewerkt 2026-07-03T18:38:49Z. 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.