In a new study, researchers found that empagliflozin, a recently developed diabetes drug, can effectively treat and reverse heart failure in both diabetic and non-diabetic patients.
They showed that this medication can improve the heart’s size, shape, and function, leading to better exercise capacity and quality of life, which will reduce hospitalizations for heart failure patients.
Importantly, the researchers noted that the drug did not appear to cause hypoglycemia, or low blood sugar, in non-diabetic patients.
The research was conducted by a team at the Icahn School of Medicine at Mount Sinai.
In the study, the researchers recruited 84 patients with chronic heart failure with reduced ejection fraction (EF) and randomized them to treatment with empagliflozin or a placebo.
Patients received treatment or placebo for six months, with some short safety visits at one and three months.
The team found about 80% of the patients treated with empagliflozin showed a big improvement, and their hearts returned to near normal.
This group had a 16.6% improvement in left ventricular ejection fraction at the six-month mark and their hearts pumped blood in a stronger way.
Their hearts became smaller, less dilated because of less congestion and less fluid accumulation in the body, meaning that their heart failure became less severe, and the walls of the heart were less thick, meaning that the left ventricle could pump blood more easily.
The placebo group showed no improvement; those patients either stayed at baseline or their condition got worse.
The study also showed that patients taking empagliflozin had roughly 10% improvement in their exercise levels, while patients on the placebo arm showed no improvement.
This showed that the empagliflozin group became healthier, could do more everyday activities, and had an improved quality of life, putting those patients at less risk of hospitalization.
The study also identified, for the first time, why this drug is effective for treating heart failure.
In heart failure, the heart goes through adverse remodeling in which the left ventricle dilates, becomes thicker (hypertrophic) and more spherical, and pumps in a weaker way with a lower ejection fraction.
The researchers showed that this drug lessens and reverses this adverse remodeling.
It reduces the dilation and hypertrophy of the left ventricle, helps the left ventricle pump more strongly (increasing the ejection fraction), and changes the shape of the left ventricle, making it more elongated and less spherical.
The researchers were very surprised at how fast the benefits appeared with empagliflozin.
Another key issue is how safe this drug is; we saw no severe side effects, despite being an antidiabetic drug, no hypoglycemia was noticed.
This shows that empagliflozin is a safe and potent treatment for heart failure with reduced ejection fraction independently of the diabetic status of the patient.
One author of the study is Carlos Santos-Gallego, MD.
The study is published in the Journal of the American College of Cardiology.
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