Changes in Left Ventricular Strain Parameters After Empagliflozin Treatment in Patients with Diabetes Mellitus and Normal Ejection Fraction

Abstract Objective: In recent years, sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to improve symptoms and reduce mortality in patients with heart failure (HF). Empagliflozin is an antidiabetic drug that SGLT-2 inhibitor. Empagliflozin has beneficial cardiac effects like other SGLT-2 inhibitors. However, data on how empagliflozin treatment affects echocardiographic parameters are limited. We aim to evaluate the changes in left ventricular myocardial strain parameters with 2-dimensional speckle tracking echocardiography (2D-STE) in patients with diabetes mellitus and normal ejection fraction after empagliflozin treatment.Material and Method: A total of 48 patients were included in our study. The left ventricular ejection fraction (LVEF) of the patients were normal and there were no HF symptoms and findings. Demographic, clinical, and echocardiographic parameters of study population were evaluated. Empagliflozin 10 mg once daily was given to all patients. Initial and at the end of 3rd month, the 2D-STE parameters of all patients were examined.Results: The median age of the study population was 55.0 (45.0 – 62.5, IQR) years and 27 (56.3 %) of them were female. There was a significant increase in the left ventricle global longutidunal strain (LV-GLS) and left ventricle global circumferential strain (LV-GCS) compared to baseline [respectively; -19.7(-17.5;-20.9) vs -19.2(-17.6;-20.2), p= 0.016 and -18.9(-16.0;-20.8) vs -17.1(-15.8;-18.7), p= 0.003]. Although left ventricular global radial strain (LV-GRS) was increased compared to baseline, it was not significant [37.0(31.0-41.6) vs 36.3(32.4-40.3), p= 0.776].Conclusion: In our study, left ventricular myocardial strain parameters such as LV-GLS and LV-GCS were improved in diabetic patients with normal ejection fraction after empagliflozin treatment.