# Empagliflozine en inspanningsvermogen bij HFrEF en HFpEF: EMPERIAL

*geplaatst 2021-02-11 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehaa943 · https://hartvaat.nl/2021/02/11/empagliflozine-en-inspanningsvermogen-bij-hfref-en-hfpef-emperial/*

EMPERIAL trial naar het effect van empagliflozine op inspanningsvermogen en symptomen bij HFrEF en HFpEF.

## English: Effect of empagliflozin on exercise ability and symptoms in heart failure patients with reduced and preserved ejection fraction, with and without type 2 diabetes.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehaa943. Bijgewerkt 2026-07-03T13:28:12Z. 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.