{"id":"75c2d2e0a539","type":"article","url":"https://hartvaat.nl/2021/02/11/empagliflozine-en-inspanningsvermogen-bij-hfref-en-hfpef-emperial/","title":"Empagliflozine en inspanningsvermogen bij HFrEF en HFpEF: EMPERIAL","title_en":"Effect of empagliflozin on exercise ability and symptoms in heart failure patients with reduced and preserved ejection fraction, with and without type 2 diabetes.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["dapa-hf","emperor-trials","step-hfpef","summit-trial"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaa943","source_url":"https://doi.org/10.1093/eurheartj/ehaa943","authors":["William T Abraham","JoAnn Lindenfeld","Piotr Ponikowski","Piergiuseppe Agostoni","Javed Butler","Akshay S Desai","Gerasimos Filippatos","Jacek Gniot","Michael Fu","Lars Gullestad","Jonathan G Howlett","Stephen J Nicholls","Josep Redon","Isabelle Schenkenberger","José Silva-Cardoso","Stefan Störk","Jerzy Krzysztof Wranicz","Gianluigi Savarese","Martina Brueckmann","Waheed Jamal","Matias Nordaby","Barbara Peil","Ivana Ritter","Anastasia Ustyugova","Cordula Zeller","Afshin Salsali","Stefan D Anker"],"significance":7,"published":"2021-02-11","source_date":"2021-02-11","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/"],"congress":"","summary_en":"The EMPERIAL trials evaluated the effect of empagliflozin on exercise ability (6-minute walk distance) and symptoms in patients with both HFrEF and HFpEF, finding modest improvements in symptom burden but no significant change in exercise capacity.","created":"2026-07-03T10:29:03Z","updated":"2026-07-03T13:28:12Z","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":"EMPERIAL trial naar het effect van empagliflozine op inspanningsvermogen en symptomen bij HFrEF en HFpEF.","abstract_original":"AIMS: The EMPERIAL (Effect of EMPagliflozin on ExeRcise ability and HF symptoms In patients with chronic heArt faiLure) trials evaluated the effects of empagliflozin on exercise ability and patient-reported outcomes in heart failure (HF) with reduced and preserved ejection fraction (EF), with and without type 2 diabetes (T2D), reporting, for the first time, the effects of sodium-glucose co-transporter-2 inhibition in HF with preserved EF (HFpEF). METHODS AND RESULTS: HF patients with reduced EF (HFrEF) (≤40%, N = 312, EMPERIAL-Reduced) or preserved EF (>40%, N = 315, EMPERIAL-Preserved), with and without T2D, were randomized to empagliflozin 10 mg or placebo for 12 weeks. The primary endpoint was 6-minute walk test distance (6MWTD) change to Week 12. Key secondary endpoints included Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS) and Chronic Heart Failure Questionnaire Self-Administered Standardized format (CHQ-SAS) dyspnoea score. 6MWTD median (95% confidence interval) differences, empagliflozin vs. placebo, at Week 12 were -4.0 m (-16.0, 6.0; P = 0.42) and 4.0 m (-5.0, 13.0; P = 0.37) in EMPERIAL-Reduced and EMPERIAL-Preserved, respectively. As the primary endpoint was non-significant, all secondary endpoints were considered exploratory. Changes in KCCQ-TSS and CHQ-SAS dyspnoea score were non-significant. Improvements with empagliflozin in exploratory pre-specified analyses of KCCQ-TSS responder rates, congestion score, and diuretic use in EMPERIAL-Reduced are hypothesis generating. Empagliflozin adverse events were consistent with those previously reported. CONCLUSION: The primary outcome for both trials was neutral. Empagliflozin was well tolerated in HF patients, with and without T2D, with a safety profile consistent with that previously reported in T2D. Hypothesis-generating improvements in exploratory analyses of secondary endpoints with empagliflozin in HFrEF were observed."}