The SGLT2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure: results from a placebo-controlled randomised trial

INTRODUCTION: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have cardiovascular protective properties in addition to the metabolic effects and represent a cornerstone of treating patients with chronic heart failure (CHF). We hypothesised that empagliflozin reduces tissue sodium content in patie...

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Detalles Bibliográficos
Autores principales: Kolwelter, Julie, Kannenkeril, Dennis, Linz, Peter, Jung, Susanne, Nagel, Armin M., Bosch, Agnes, Ott, Christian, Bramlage, Peter, Nöh, Lisa, Schiffer, Mario, Uder, Michael, Achenbach, Stephan, Schmieder, Roland E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Original Paper
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849317/
https://www.ncbi.nlm.nih.gov/pubmed/36289063
http://dx.doi.org/10.1007/s00392-022-02119-7
Descripción
Sumario:INTRODUCTION: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have cardiovascular protective properties in addition to the metabolic effects and represent a cornerstone of treating patients with chronic heart failure (CHF). We hypothesised that empagliflozin reduces tissue sodium content in patients with CHF. METHODS: In a double-blind, randomised (2:1), placebo-controlled, parallel-group, clinical trial, 74 patients with NYHA class II–III CHF and an ejection fraction of 49% or less received empagliflozin 10 mg once daily or placebo for 3 months. In each patient, tissue sodium content of the lower leg was assessed non-invasively by sodium-MRI ((23)Na-MRI) at baseline, after 1 and 3 months of treatment. RESULTS: After 1 and 3 months treatment with empagliflozin (n = 48), a significant decrease in skin sodium content was observed (1 month: 22.8 ± 6.1 vs. 21.6 ± 6.0 AU, p = 0.039; 3 months: 22.9 ± 6.1 vs. 21.6 ± 6.1 AU, p = 0.013), while there was no change in muscle sodium and muscle water content. In direct comparison, the change in skin sodium content between baseline and 3 months was − 1.3 ± 3.5 AU in the empagliflozin group versus 0.6 ± 3.5 AU in the placebo group (p for between-group difference = 0.022). No significant difference regarding change in muscle sodium and in muscle water content was observed after 3 months treatment between the two groups. CONCLUSION: This trial showed a significant decrease in skin sodium content after 1 and 3 months of treatment with empagliflozin. The decrease in skin sodium content may reflect a decrease in subclinical micro-oedema or/and in non-osmotic bound tissue sodium, both reported to impair left ventricular function. TRIAL REGISTRATION NUMBER: NCT03128528 (http://www.clinicaltrials.gov). TRIAL REGISTRATION DATE: 25th April 2017. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00392-022-02119-7.

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