The impact of empagliflozin and metformin on cardiac parameters in patients with mid-range ejection fraction heart failure without diabetes
Heart failure (HF) remains a significant problem for healthcare systems, requiring the use of intervention and multimodal management strategies. We aimed to assess the short-term effect of empagliflozin (EMPA) and metformin on cardiac function parameters, including ventricular dimension-hypertrophy,...
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| Veröffentlicht in: | Journal of medicine and life 2024-01, Vol.17 (1), p.57-62 |
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| creator | Sabbar, Reeman Kadhim, Sinaa Abdul Amir Fawzi, Hayder Adnan Flayih, Ali Mohammad, Bassim Swadi, Asma |
| description | Heart failure (HF) remains a significant problem for healthcare systems, requiring the use of intervention and multimodal management strategies. We aimed to assess the short-term effect of empagliflozin (EMPA) and metformin on cardiac function parameters, including ventricular dimension-hypertrophy, septal thickness, ejection fraction (EF), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with HF and mildly reduced EF. A case-control study included 60 newly diagnosed patients with HF. Patients were divided into two groups: Group E received standard HF treatment (carvedilol, bumetanide, sacubitril-valsartan, spironolactone) plus EMPA 10 mg daily, and Group M received standard HF treatment plus metformin 500 mg daily. After three months of treatment, Group E had a significantly higher EF than Group M compared to initial measurements (a change of 9.2% versus 6.1%, respectively). We found similar results in the left ventricular end-systolic dimension (LVESD), with mean reductions of 0.72 mm for Group E and 0.23 mm for Group M. Regarding cardiac indicators, the level of NT-proBNP was considerably decreased in both groups. However, the reduction was significantly greater in group E than in group M compared to the initial level (mean reduction: 719.9 vs. 973.6, respectively). When combined with quadruple anti-heart failure therapy, metformin enhanced several echocardiographic parameters, showing effects similar to those of EMPA when used in the same treatment regimen. However, the benefits of EMPA were more pronounced, particularly regarding improvements in EF and LVESD. |
| doi_str_mv | 10.25122/jml-2023-0340 |
| format | Article |
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We aimed to assess the short-term effect of empagliflozin (EMPA) and metformin on cardiac function parameters, including ventricular dimension-hypertrophy, septal thickness, ejection fraction (EF), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with HF and mildly reduced EF. A case-control study included 60 newly diagnosed patients with HF. Patients were divided into two groups: Group E received standard HF treatment (carvedilol, bumetanide, sacubitril-valsartan, spironolactone) plus EMPA 10 mg daily, and Group M received standard HF treatment plus metformin 500 mg daily. After three months of treatment, Group E had a significantly higher EF than Group M compared to initial measurements (a change of 9.2% versus 6.1%, respectively). We found similar results in the left ventricular end-systolic dimension (LVESD), with mean reductions of 0.72 mm for Group E and 0.23 mm for Group M. Regarding cardiac indicators, the level of NT-proBNP was considerably decreased in both groups. However, the reduction was significantly greater in group E than in group M compared to the initial level (mean reduction: 719.9 vs. 973.6, respectively). When combined with quadruple anti-heart failure therapy, metformin enhanced several echocardiographic parameters, showing effects similar to those of EMPA when used in the same treatment regimen. However, the benefits of EMPA were more pronounced, particularly regarding improvements in EF and LVESD.</description><identifier>ISSN: 1844-3117</identifier><identifier>ISSN: 1844-122X</identifier><identifier>EISSN: 1844-3117</identifier><identifier>DOI: 10.25122/jml-2023-0340</identifier><identifier>PMID: 38737651</identifier><language>eng</language><publisher>Romania: Carol Daila University Foundation</publisher><subject>Aged ; Antidiabetics ; Benzhydryl Compounds - pharmacology ; Benzhydryl Compounds - therapeutic use ; Blood pressure ; Case-Control Studies ; Clinical trials ; Congestive heart failure ; Diabetes ; Diabetes mellitus ; Echocardiography ; Ejection fraction ; Fatty acids ; Female ; Glucose ; Glucosides - pharmacology ; Glucosides - therapeutic use ; Heart failure ; Heart Failure - drug therapy ; Heart Failure - physiopathology ; Hemoglobin ; Humans ; Kinases ; Male ; Metabolism ; Metformin ; Metformin - pharmacology ; Metformin - therapeutic use ; Middle Aged ; Mortality ; Natriuretic Peptide, Brain - blood ; Original ; Oxidation ; Patients ; Peptide Fragments - blood ; Peptides ; Proteins ; Sample size ; Sodium-Glucose Transporter 2 Inhibitors - pharmacology ; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use ; Stroke Volume - drug effects</subject><ispartof>Journal of medicine and life, 2024-01, Vol.17 (1), p.57-62</ispartof><rights>2024 by the authors.</rights><rights>Copyright Carol Daila University Foundation Jan 2024</rights><rights>2024 by the authors. 2024</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2890-1fb001967bfe9f85da05368e7c58edf8270781ca57c2048605e2ca814bdf28e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080507/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080507/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38737651$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sabbar, Reeman</creatorcontrib><creatorcontrib>Kadhim, Sinaa Abdul Amir</creatorcontrib><creatorcontrib>Fawzi, Hayder Adnan</creatorcontrib><creatorcontrib>Flayih, Ali</creatorcontrib><creatorcontrib>Mohammad, Bassim</creatorcontrib><creatorcontrib>Swadi, Asma</creatorcontrib><creatorcontrib>Department of Pharmacy, Al-Mustafa University College, Baghdad, Iraq</creatorcontrib><creatorcontrib>Department of Pharmacology, College of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq</creatorcontrib><title>The impact of empagliflozin and metformin on cardiac parameters in patients with mid-range ejection fraction heart failure without diabetes</title><title>Journal of medicine and life</title><addtitle>J Med Life</addtitle><description>Heart failure (HF) remains a significant problem for healthcare systems, requiring the use of intervention and multimodal management strategies. We aimed to assess the short-term effect of empagliflozin (EMPA) and metformin on cardiac function parameters, including ventricular dimension-hypertrophy, septal thickness, ejection fraction (EF), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with HF and mildly reduced EF. A case-control study included 60 newly diagnosed patients with HF. Patients were divided into two groups: Group E received standard HF treatment (carvedilol, bumetanide, sacubitril-valsartan, spironolactone) plus EMPA 10 mg daily, and Group M received standard HF treatment plus metformin 500 mg daily. After three months of treatment, Group E had a significantly higher EF than Group M compared to initial measurements (a change of 9.2% versus 6.1%, respectively). We found similar results in the left ventricular end-systolic dimension (LVESD), with mean reductions of 0.72 mm for Group E and 0.23 mm for Group M. Regarding cardiac indicators, the level of NT-proBNP was considerably decreased in both groups. However, the reduction was significantly greater in group E than in group M compared to the initial level (mean reduction: 719.9 vs. 973.6, respectively). When combined with quadruple anti-heart failure therapy, metformin enhanced several echocardiographic parameters, showing effects similar to those of EMPA when used in the same treatment regimen. However, the benefits of EMPA were more pronounced, particularly regarding improvements in EF and LVESD.</description><subject>Aged</subject><subject>Antidiabetics</subject><subject>Benzhydryl Compounds - pharmacology</subject><subject>Benzhydryl Compounds - therapeutic use</subject><subject>Blood pressure</subject><subject>Case-Control Studies</subject><subject>Clinical trials</subject><subject>Congestive heart failure</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Echocardiography</subject><subject>Ejection fraction</subject><subject>Fatty acids</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucosides - pharmacology</subject><subject>Glucosides - therapeutic use</subject><subject>Heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - physiopathology</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Kinases</subject><subject>Male</subject><subject>Metabolism</subject><subject>Metformin</subject><subject>Metformin - 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pharmacology</topic><topic>Benzhydryl Compounds - therapeutic use</topic><topic>Blood pressure</topic><topic>Case-Control Studies</topic><topic>Clinical trials</topic><topic>Congestive heart failure</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Echocardiography</topic><topic>Ejection fraction</topic><topic>Fatty acids</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucosides - pharmacology</topic><topic>Glucosides - therapeutic use</topic><topic>Heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - physiopathology</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Kinases</topic><topic>Male</topic><topic>Metabolism</topic><topic>Metformin</topic><topic>Metformin - pharmacology</topic><topic>Metformin - therapeutic use</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Original</topic><topic>Oxidation</topic><topic>Patients</topic><topic>Peptide Fragments - blood</topic><topic>Peptides</topic><topic>Proteins</topic><topic>Sample size</topic><topic>Sodium-Glucose Transporter 2 Inhibitors - pharmacology</topic><topic>Sodium-Glucose Transporter 2 Inhibitors - therapeutic use</topic><topic>Stroke Volume - drug effects</topic><toplevel>online_resources</toplevel><creatorcontrib>Sabbar, Reeman</creatorcontrib><creatorcontrib>Kadhim, Sinaa Abdul Amir</creatorcontrib><creatorcontrib>Fawzi, Hayder Adnan</creatorcontrib><creatorcontrib>Flayih, Ali</creatorcontrib><creatorcontrib>Mohammad, Bassim</creatorcontrib><creatorcontrib>Swadi, Asma</creatorcontrib><creatorcontrib>Department of Pharmacy, Al-Mustafa University College, Baghdad, Iraq</creatorcontrib><creatorcontrib>Department of Pharmacology, College of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>East Europe, Central Europe Database</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medicine and life</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sabbar, Reeman</au><au>Kadhim, Sinaa Abdul Amir</au><au>Fawzi, Hayder Adnan</au><au>Flayih, Ali</au><au>Mohammad, Bassim</au><au>Swadi, Asma</au><aucorp>Department of Pharmacy, Al-Mustafa University College, Baghdad, Iraq</aucorp><aucorp>Department of Pharmacology, College of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of empagliflozin and metformin on cardiac parameters in patients with mid-range ejection fraction heart failure without diabetes</atitle><jtitle>Journal of medicine and life</jtitle><addtitle>J Med Life</addtitle><date>2024-01</date><risdate>2024</risdate><volume>17</volume><issue>1</issue><spage>57</spage><epage>62</epage><pages>57-62</pages><issn>1844-3117</issn><issn>1844-122X</issn><eissn>1844-3117</eissn><abstract>Heart failure (HF) remains a significant problem for healthcare systems, requiring the use of intervention and multimodal management strategies. We aimed to assess the short-term effect of empagliflozin (EMPA) and metformin on cardiac function parameters, including ventricular dimension-hypertrophy, septal thickness, ejection fraction (EF), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with HF and mildly reduced EF. A case-control study included 60 newly diagnosed patients with HF. Patients were divided into two groups: Group E received standard HF treatment (carvedilol, bumetanide, sacubitril-valsartan, spironolactone) plus EMPA 10 mg daily, and Group M received standard HF treatment plus metformin 500 mg daily. After three months of treatment, Group E had a significantly higher EF than Group M compared to initial measurements (a change of 9.2% versus 6.1%, respectively). We found similar results in the left ventricular end-systolic dimension (LVESD), with mean reductions of 0.72 mm for Group E and 0.23 mm for Group M. Regarding cardiac indicators, the level of NT-proBNP was considerably decreased in both groups. However, the reduction was significantly greater in group E than in group M compared to the initial level (mean reduction: 719.9 vs. 973.6, respectively). When combined with quadruple anti-heart failure therapy, metformin enhanced several echocardiographic parameters, showing effects similar to those of EMPA when used in the same treatment regimen. However, the benefits of EMPA were more pronounced, particularly regarding improvements in EF and LVESD.</abstract><cop>Romania</cop><pub>Carol Daila University Foundation</pub><pmid>38737651</pmid><doi>10.25122/jml-2023-0340</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antidiabetics Benzhydryl Compounds - pharmacology Benzhydryl Compounds - therapeutic use Blood pressure Case-Control Studies Clinical trials Congestive heart failure Diabetes Diabetes mellitus Echocardiography Ejection fraction Fatty acids Female Glucose Glucosides - pharmacology Glucosides - therapeutic use Heart failure Heart Failure - drug therapy Heart Failure - physiopathology Hemoglobin Humans Kinases Male Metabolism Metformin Metformin - pharmacology Metformin - therapeutic use Middle Aged Mortality Natriuretic Peptide, Brain - blood Original Oxidation Patients Peptide Fragments - blood Peptides Proteins Sample size Sodium-Glucose Transporter 2 Inhibitors - pharmacology Sodium-Glucose Transporter 2 Inhibitors - therapeutic use Stroke Volume - drug effects |
| title | The impact of empagliflozin and metformin on cardiac parameters in patients with mid-range ejection fraction heart failure without diabetes |
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