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

Kolwelter J, Kannenkeril D, Linz P, Jung S, Nagel AM, Bosch A, Ott C, Bramlage P, Nöh L, Schiffer M, Uder M, Achenbach S, Schmieder R (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Clinical Research in Cardiology Springer Verlag (Germany)

DOI: 10.1007/s00392-022-02119-7

Abstract

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 (23Na-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.

Authors with CRIS profile

Julie Kolwelter Department of Medicine 2 – Cardiology and Angiology Peter Linz Interdisziplinäres Zentrum für Klinische Forschung IZKF-Förderlinien Armin Michael Nagel Professur für metabolische und funktionelle MR-Bildgebung Agnes Bosch Department of Medicine 4 – Nephrology and Hypertension Christian Ott Department of Medicine 4 – Nephrology and Hypertension Mario Schiffer Lehrstuhl für Innere Medizin IV Michael Uder Lehrstuhl für Diagnostische Radiologie Stephan Achenbach Lehrstuhl für Innere Medizin II Roland Schmieder Professur für Innere Medizin (Nephrologie)

Involved external institutions

IPPMed - Institut für Pharmakologie und Präventive Medizin GmbH DE Germany (DE)

How to cite

APA:

Kolwelter, J., Kannenkeril, D., Linz, P., Jung, S., Nagel, A.M., Bosch, A.,... Schmieder, R. (2022). The SGLT2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure: results from a placebo-controlled randomised trial. Clinical Research in Cardiology. https://dx.doi.org/10.1007/s00392-022-02119-7

MLA:

Kolwelter, Julie, et al. "The SGLT2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure: results from a placebo-controlled randomised trial." Clinical Research in Cardiology (2022).

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