Effects of Empagliflozin on  Cardiac Structure in Patients With Type 2 Diabetes  The EMPA-HEART CardioLink-6 Trial

Empagliflozin is an SGLT2 inhibitor drug that is used for the treatment of adult onset diabetes. It was the first approved diabetes drug that was shown to reduce heart failure-associated death and hospitalization amongst persons with type 2 diabetes.  The available evidence at the time suggested that the cardioprotective effects were unlikely due improvements in diabetes control (lower blood glucose levels) nor slowing of the atherosclerotic (narrowing of arteries due to plaque build up) process. Using the gold standard cardiac magnetic resonance imaging (cMRI) technique, the EMPA-HEART CardioLink-6 trial showed that empagliflozin use led to clinically meaningful and beneficial regression of the left ventricular mass (i.e. decrease in weight of the left lower heart chamber) in patients living with cardiovascular disease and type 2 diabetes. This observation suggested that beneficial left ventricular remodelling may account, at least in part, for the heart failure reduction documented among SGLT2-inhibitor-treated people with type 2 diabetes. The EMPA-HEART findings were presented at a Late-Breaking trial session of the 2018 AHA Scientific Sessions and the primary results were published in Circulation (Verma et al. 2019)