EFFECT OF EMPAGLIFLOZIN ON CARDIAC REMODELING IN PATIENTS WITH TYPE 2 DIABETES AND HEART FAILURE WITH REDUCED EJECTION FRACTION

Abstract

HFxEF often occurs in conjunction with type 2 diabetes mellitus and has remained linked to poor ventricular remodeling, increased hospital admissions, decreased functional capacity and early death.Sodium-glucose cotransporter-2 inhibitors have been shown to have beneficial cardiovascular effects in patients with heart and/or blood failure and reduced ejection fraction (HFrEF), but the short-term impact on echocardiographic cardiac-remodeling parameters still have clinical significance, especially in the South Asian population.

Objective:To compare the changes in LVEF, LVEDV and LVESV after 12 weeks of empagliflozin plus standard-of-care versus standard-of-care in patients with T2D and HF with reduced ejection fraction.

Methodology: It’s a randomized controlled research which was designed based on the approved college of Physicians and Surgeons Pakistan synopsis.A total of 76 participants with synthetic records were assigned to Group A to receive empagliflozin 10 mg/day and standard guideline-directed treatment (GDMT), or to Group B where participants would receive standard treatment alone.The period of time represented was January to June 2026 and participants were followed for 12 weeks.Baseline and 12-week echocardiographic measurements were taken.Paired samples t investigations were used to determine within group changes.Welch independent-samples t tests were used to test for among group alterations in change grooves.The effects were adjusted using regression examination of covariance with the baseline outcome as the covariate, age and sex, and baseline NYHA functional class.

Results: Follow up was achieved with all 76 synthetic participants.Each group was similar at the beginning of the study. Mean left ventricular discharge fraction increased from 31.9 ± 4.4% to 37.5 ± 4.5% in Group A and from 32.8 ± 4.3% to 34.8 ± 5.0% in Group B. At 30 days, the mean difference in change of ejection-fraction between the two teams was 3.55 percentage points (95 % CI: 2.54–4.57; p<0.001). Left ventricular end-diastolic volume decreased by 11.6 ± 6.2 mL in Group A and 3.9 ± 7.7 mL in Group B, with a mean between-group difference of −7.66 mL (95% confidence interval, −10.86 to −4.47; p<0.001). Left ventricular end-systolic volume reduced by 17.1 ± 6.0 mL and 6.1 ± 5.3 mL, respectively, producing a difference of −11.00 mL (95% confidence interval, −13.58 to −8.42; p<0.001). 29/38 (76.3%) in Group A and 13/38 (34.2%) in Group B achieved at least one improvement at the end of the study in the NYHA functional class, p<0.001.

Conclusion:In this synthetic analysis, empagliflozin treatment plus standard treatment resulted in more improvement in LVEF and more decreases in both LVEDV and LVESV at 12 weeks than standard treatment alone.The results are preliminary and need to be validated with prospectively collected and validated clinical data.