Effect of empagliflozin on the left ventricular diastolic function in patients with type 2 diabetes mellitus and concomitant heart failure with preserved ejection fraction

Background. Heart failure with preserved ejection fraction is a common disease affecting more than half of people with heart failure. Among the extracardiac proinflammatory conditions, type 2 diabetes mellitus, which occurs in approximately 30–40 % of patients with heart failure, deserves special attention. The purpose of the study is to evaluate the effect of empagliflozin on the left ventricular diastolic function in patients with type 2 diabetes mellitus and concomitant heart failure with preserved ejection fraction. Materials and methods. One hundred and twenty patients met the study criteria and were randomized in a 1 : 1 ratio to the empagliflozin group (n = 60) or the control group (n = 60), which received other antidiabetic drugs. The follow-up period lasted 12 weeks. A transthoracic echocardiogram was performed and functional and structural changes of the heart in these diseases were identified. Results. The data showed a marked improvement in several cardiac parameters. One important result was a decrease in the left ventricular mass index, which indicates a reduction in the left ventricular size and hypertrophy. This reduction shows a favorable course of remodeling and a potential regression of cardiac remodeling under the influence of empagliflozin. In addition, the study demonstrated an improvement in the left ventricular diastolic function. In particular, deceleration time and the E/e’ ratio showed favorable changes. Deceleration time, which reflects the relaxation and compliance of the left ventricle, decreased significantly, indicating an improvement in diastolic function. The E/e’ ratio, a marker of the left ventricular filling pressure, also showed positive changes, indicating a decrease in cardiac tension and improved ventricular relaxation. Conclusions. The results of the study demonstrated that empagliflozin treatment has a posi­tive effect on various cardiovascular parameters in patients with the studied diseases, in particular on the left ventricular diastolic function. These findings contribute to our understanding of the therapeutic potential of empagliflozin in the management of cardiovascular diseases.