Heart Failure Clinical Trial

Impact of Empagliflozin on Functional Capacity in Heart Failure With Preserved Ejection Fraction

Summary

Sodium-Glucose Cotransporter-2 (SGLT-2) inhibitors generally and empagliflozin specifically have shown cardiovascular benefits in patients with heart failure (HF), but the underlying mechanisms remain unclear. Empagliflozin use resulted in lower pulmonary artery diastolic pressures in patients with HF, suggesting a beneficial diuretic effect. Other potential mechanisms include increased blood volume, decreased blood pressure, and changes in sympathetic and neuro-hormonal activation.

This study is a single-arm, open label, prospective interventional study of 8 subjects with heart failure with preserved ejection fraction (HFpEF). Before and after 12 weeks of daily empagliflozin, participants with undergo comprehensive invasive exercise testing with a right heart catheter. Our goal is to evaluate the effects of empagliflozin on fitness, assessed by peak VO2, and peak left ventricular filling pressure, assessed by pulmonary capillary pressure at peak exercise.

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Full Description

This is a single-arm, open label, pilot study of 8 subjects with HFpEF. The subjects will undergo screening tests (exercise stress echo and blood work) to evaluate for potential exclusion criteria and provide familiarization to the exercise protocol. Those included will undergo an echocardiogram and invasive cardiopulmonary exercise test. This involves placement of a right heart catheter in the pulmonary artery and undergoing seated, upright exercise. During the exercise test, the subject's oxygen uptake (VO2), intra-cardiac pressures (right atrial pressure, pulmonary capillary wedge pressure) and cardiac output (Qc) will be measured. The subject will take a dose of empagliflozin in the lab and wait for at least 60 minutes. They will repeat a shortened version of the exercise test in the afternoon. After baseline testing, each subject will take 10mg empagliflozin daily for 12 weeks. They will have repeat blood work (specific electrolytes and renal function) 30 days after starting medication to screen for renal injury. After 12 weeks, they will return for another invasive cardiopulmonary exercise test and echocardiogram.

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Eligibility Criteria

Inclusion Criteria:

adults ages 50-85
clinical heart failure
ejection fraction > 50%

Exclusion Criteria:

previous hypersensitivity or adverse reaction to SGLT-2 inhibitors
currently treated with SGLT-2 inhibitor
current or prior ejection fraction <50%
chronic kidney disease with glomerular filtration rate < 45 ml/kg/min
unstable coronary artery disease
significant arrhythmia
BMI >55 kg/m2
inability to exercise.

Study is for people with:

Heart Failure

Phase:

Phase 3

Estimated Enrollment:

8

Study ID:

NCT05139472

Recruitment Status:

Completed

Sponsor:

University of Texas Southwestern Medical Center

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There are 2 Locations for this study

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Institute for Exercise and Environmental Medicine
Dallas Texas, 75231, United States
University of Texas Southwestern Medical Center
Dallas Texas, 75390, United States

How clear is this clinincal trial information?

Study is for people with:

Heart Failure

Phase:

Phase 3

Estimated Enrollment:

8

Study ID:

NCT05139472

Recruitment Status:

Completed

Sponsor:


University of Texas Southwestern Medical Center

How clear is this clinincal trial information?

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