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We know from large clinical trials that sodium–glucose cotransporter-2 (SGLT-2) inhibitors improve outcomes for patients with heart failure (HF), even in the absence of diabetes. But how do these agents affect the structure and function of the heart? Investigators randomized 84 patients with HF with reduced ejection fraction (HFrEF) to empagliflozin (10 mg daily) or placebo for 6 months and measured left ventricular volumes (by magnetic resonance imaging) and ejection fraction.
At 6 months, left ventricular volume and mass decreased significantly and ejection fraction increased by an average of 6 percentage points from baseline (from 36.2% to 42.2%) with empagliflozin. Empagliflozin patients had significantly higher peak oxygen uptake on car…