- Nesti L, Pugliese NR, Sciuto P, et al. Mechanisms of reduced peak oxygen consumption in subjects with uncomplicated type 2 diabetes. Cardiovasc Diabetol. 2021;20(1):124.
- Nesti L, Pugliese NR, Sciuto P, Natali A. Type 2 diabetes and reduced exercise tolerance: a review of the literature through an integrated physiology approach. Cardiovasc Diabetol. 2020;19(1):134.
- Natali A, Nesti L, Fabiani I, Calogero E, Di Bello V. Impact of empagliflozin on subclinical left ventricular dysfunctions and on the mechanisms involved in myocardial disease progression in type 2 diabetes: rationale and design of the EMPA-HEART trial. Cardiovasc Diabetol. 2017;16(1):130.
Perspective
How does this study impact clinical practice?
- This data supports the hypothesis that SGLT2 inhibitors can directly affect myocardial contractility in selected patients with subclinical LV systolic dysfunction, possibly justifying their benefit in HF primary prevention.
- When treated with empagliflozin, patients with pathologic baseline GLS values (but normal LVEF values) rapidly increase to GLS values that are close to normal.
- Patients with normal LVEF but reduced GLS values at baseline, who are not addressed with current guidelines for the prevention of CVD, may benefit more from therapy with SGLT2 inhibitors such as empagliflozin.
