Heart failure & cardiomyopathiesRandomised controlled trial
Effects of empagliflozin on right ventricular free-wall strain in patients with heart failure and reduced ejection fraction: results from the Empire HF Trial
- investigator-initiated, double-blind, randomized, placebo-controlled trial
- exploratory substudy
Authors' conclusion
This exploratory substudy of the Empire HF, treatment with empagliflozin exerted no overall effect on RV function in stable HFrEF patients, but significantly improved RVFWS in patients in the lowest tertile of RVFWS after 12 weeks of treatment.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (left ventricular ejection fraction (LVEF) of 40% or lower) and New York Heart Association (NYHA) Class I–III symptomsincluded in this substudy, of 190 patients enrolled in the Empire HF trial
- Participants
- 160 patients
- Comparison
- empagliflozin vs placebo
- Primary endpoint
- Changes in RV free wall strain (RVFWS) across the whole cohort
- Follow-up
- 12 weeks
Primary result
As reported in the abstract
- No differences were observed in RV free wall strain (RVFWS) between the groups
Secondary outcomes
Mean, %
| Outcome | empagliflozin | placebo | treatment effect (95% CI) | P value |
|---|---|---|---|---|
| Baseline RVFWS | −16.4 (SD 6.2) | −16.9 (SD 5.9) | ||
| RVFWS, lowest tertile of baseline RVFWS (subgroup) · 12 weeks · significant improvement with empagliflozin | −2.9% (−5.0 to −0.3) | P = 0.027 |
- Baseline RVFWS — overall mean RVFWS
- −16.7 ± 6.1%
- RVFWS, lowest tertile of baseline RVFWS (subgroup): independent of LVEF, plasma volume, and weight loss, and unchanged after additional adjustment for left ventricular (LV) remodelling and the presence of resynchronization therapy
RVFWS middle and highest tertiles; Tricuspid annular plane systolic excursion (TAPSE) and right ventricular (RV) S’ overall and lowest tertiles
- No significant treatment effect
Original publication
Effects of empagliflozin on right ventricular free-wall strain in patients with heart failure and reduced ejection fraction: results from the Empire HF Trial. ESC Heart Fail. Published 8 January 2026. doi:10.1093/eschf/xvaf031
Summarised from the published abstract; every number is checked against it