Randomised controlled trial
Assessment of Cardiac Energy Metabolism, Function, and Physiology in Patients With Heart Failure Taking Empagliflozin: The Randomized, Controlled EMPA-VISION Trial
- Randomised controlled trial
- prospective
- double-blind
- placebo-controlled
- mechanistic
- stratified by HF with reduced ejection fraction (HFrEF) vs HF with preserved ejection fraction (HFpEF) cohort
Authors' conclusion
In patients with either HFrEF or HFpEF, treatment with 10 mg of empagliflozin once daily for 12 weeks did not improve cardiac energetics or change circulating serum metabolites associated with energy metabolism when compared with placebo.
Study context
- Population
- Symptomatic patients with chronic HFrEF (LVEF ≤40%) or HFpEF (LVEF ≥50%), NYHA class ≥II, NT-proBNP ≥125 pg/mLHFrEF n=36
- Participants
- 72 patients
- Comparison
- Empagliflozin vs placebo
- Empagliflozinn = 35
- Placebon = 37reference
- Primary endpoint
- Change in cardiac PCr/ATP ratio by phosphorus magnetic resonance spectroscopy at rest and during peak dobutamine stress
- Follow-up
- Baseline to week 12
Primary result
As reported in the abstract
Change in cardiac PCr/ATP, baseline to week 12 · week 12
Empagliflozin vs PlaceboAdjusted mean treatment difference (95% CI)P value
at rest, HFrEF
−0.25(−0.58 to 0.09)
P = 0.14at rest, HFpEF
−0.16(−0.60 to 0.29)
P = 0.47- No changes in PCr/ATP during dobutamine stress, HFrEF: adjusted mean treatment difference
- −0.13 (95% CI, −0.35 to 0.09); P=0.23
- No changes in PCr/ATP during dobutamine stress, HFpEF: adjusted mean treatment difference
- −0.22 (95% CI, −0.66 to 0.23); P=0.32
Further findings
Serum metabolomics and circulating ketone bodies
- No changes in serum metabolomics or circulating ketone bodies
Original publication
Assessment of Cardiac Energy Metabolism, Function, and Physiology in Patients With Heart Failure Taking Empagliflozin: The Randomized, Controlled EMPA-VISION Trial. Circulation. Published 18 April 2023. doi:10.1161/circulationaha.122.062021
Summarised from the published abstract; every number is checked against it