Table 2.
Effects in heart failure with preserved ejection fraction: animal and human studies
| Author, year | Study characteristics | Main findings |
|---|---|---|
| Animal studies | ||
| Habibi et al. 2017 [31] | Studied diastolic function in obese female db/db mice fed chow with or without empagliflozin | Empagliflozin associated with improved left ventricular filling pressure and less interstitial fibrosis vs. control animals |
| Connelly et al. 2020 [43] | Pressure-volume (P-V) relationship analysis used to study changes in cardiac function in animals with experimental myocardial infarction | Empagliflozin therapy improved cardiac function independent of loading condition |
| Pabel et al. 2018 [33] | Performed contractility experiments with in toto-isolated systolic end-stage HF ventricular trabeculae from mice | Empagliflozin had direct pleiotropic effects on myocardium by improving diastolic stiffness and diastolic function |
| Lee et al. 2019 [34] | Studied cardiac hemodynamics in rats with induced non-diabetic hypertensive heart failure | Empagliflozin improved hemodynamics and attenuated cardiac fibrosis |
| Cappetta et al. 2020 [35] | Studied diastolic function in rats with induced non-diabetic HFpEF | Dapagliflozin improved diastolic function and had a positive effect on the myocardium |
| Zhang et al. 2019 [36] | Hypertension/hyperlipidemia-induced HFpEF pig model given dapagliflozin for 9 weeks | Dapagliflozin significantly diminished cardiac concentric remodeling with no changes in diastolic function |
| Kolijn et al. 2021 [37] | Obesity model of HFpHF in rats | Empagliflozin suppressed increased levels of ICAM-1, VCAM-1, TNF-α, and IL-6 in myocardium |
| Zhang et al. [39] | Mouse model of HFpEF | Expression of HMGB1 was increased in cardiac tissue and decreased by empagliflozin |
| Human studies | ||
| Soga et al. 2021 [40] | Patients who had been administered at least 1 antidiabetic agent other than an SGLT-2i treated with dapagliflozin for 6 months | Left ventricular diastolic function ratio of (mitral inflow E to the mitral e’ annular velocities [E/e’]) significantly decreased |
| Tanaka et al. 2020 [41] | Patients who had been administered at least 1 antidiabetic agent other than an SGLT-2i treated with dapagliflozin for 6 months | Improvement of LV longitudinal myocardial function, which led to further improve |
HF, heart failure; HFpEF, heart failure with preserved ejection fraction; LV, left ventricular