Effects of empagliflozin on cardiorespiratory fitness and significant interaction of loop diuretics

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2018-08, Vol.20 (8), p.2014-2018
• Main Authors: Carbone, Salvatore, Canada, Justin M., Billingsley, Hayley E., Kadariya, Dinesh, Dixon, Dave L., Trankle, Cory R., Buckley, Leo F., Markley, Roshanak, Vo, Chau, Medina de Chazal, Horacio, Christopher, Sanah, Buzzetti, Raffaella, Van Tassell, Benjamin W., Abbate, Antonio
• Format: Article
• Language: English
• Subjects: Benzhydryl Compounds - adverse effects; Benzhydryl Compounds - therapeutic use; Body Mass Index; Body weight; Cardiorespiratory Fitness; Cohort Studies; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetic Cardiomyopathies - drug therapy; Diabetic Cardiomyopathies - metabolism; Diabetic Cardiomyopathies - physiopathology; Diuretics; Drug Interactions; empagliflozin; Female; Glucosides - adverse effects; Glucosides - therapeutic use; Heart - drug effects; Heart - physiopathology; Heart diseases; Heart failure; Heart Failure - complications; Heart Failure - drug therapy; Heart Failure - metabolism; Heart Failure - physiopathology; Humans; Male; Middle Aged; Obesity - complications; Oxygen Consumption; Pilot Projects; Respiratory System - drug effects; Respiratory System - physiopathology; SGLT2 inhibitors; Sodium Potassium Chloride Symporter Inhibitors - adverse effects; Sodium Potassium Chloride Symporter Inhibitors - therapeutic use; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Stroke Volume - drug effects
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.13309

The effects of empagliflozin on cardiorespiratory fitness in patients with type 2 diabetes mellitus (T2DM) and heart failure with reduced ejection fraction (HFrEF) are unknown. In this pilot study we determined the effects of empagliflozin 10 mg/d for 4 weeks on peak oxygen consumption (VO2) in 15 patients with T2DM and HFrEF. As an exploratory analysis, we assessed whether there was an interaction of the effects of empagliflozin on peak VO2 of loop diuretics. Empagliflozin reduced body weight (−1.7 kg; P = .031), but did not change peak VO2 (from 14.5 mL kg−1 min−1 [12.6‐17.8] to 15.8 [12.5‐17.4] mL kg−1 min−1; P = .95). However, patients using loop diuretics (N = 9) demonstrated an improvement, whereas those without loop diuretics (N = 6) experienced a decrease in peak VO2 (+0.9 [0.1‐1.4] vs −0.9 [−2.1 to −0.3] mL kg−1 min−1; P = .001), and peak VO2 changes correlated with the baseline daily dose of diuretics (R = +0.83; P