From the Guidelines
Empagliflozin has been shown to be beneficial in reducing the risk of heart failure hospitalizations and cardiovascular death in patients with heart failure, including those with right ventricular failure, as demonstrated in the EMPEROR-Preserved trial 1. The typical dosing of empagliflozin is 10mg once daily, which can be increased to 25mg daily if needed and tolerated. Empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has shown promise in improving cardiac function, reducing pulmonary pressures, and decreasing heart failure hospitalizations in patients with both left and right heart failure. Some key points to consider when using empagliflozin in patients with right ventricular failure include:
- Monitoring for potential side effects, including genital mycotic infections, urinary tract infections, volume depletion, and hypoglycemia (particularly if on insulin or sulfonylureas) 1
- Assessing renal function before initiation and periodically during treatment 1
- Advising patients to maintain adequate hydration and to temporarily discontinue the medication during periods of reduced oral intake or significant fluid losses to prevent dehydration and acute kidney injury 1 The benefits of empagliflozin in patients with heart failure have been consistently demonstrated across multiple trials, including the EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58, and CREDENCE trials 1. Overall, the use of empagliflozin in patients with right ventricular failure may be beneficial in reducing the risk of heart failure hospitalizations and cardiovascular death, and its use should be considered in the context of individual patient needs and medical history.
From the Research
Empagliflozin and Right Ventricular Failure
- The provided studies do not directly address the relationship between Empagliflozin and right ventricular failure 2, 3, 4, 5, 6.
- However, the studies suggest that Empagliflozin has a beneficial effect on heart failure outcomes, including reduced risk of hospitalization for heart failure and cardiovascular death, in patients with type 2 diabetes and established cardiovascular disease 2, 4.
- Empagliflozin has also been shown to improve outcomes in patients with heart failure, regardless of the presence or absence of diabetes, and across the spectrum of heart failure risk 3, 5.
- The mechanism of Empagliflozin's benefit in heart failure is not fully understood, but it is thought to involve its effects on sodium-glucose cotransporter 2 inhibition, which may lead to improvements in cardiac function and reduction in hospitalizations for heart failure 6.
Heart Failure Outcomes with Empagliflozin
- Empagliflozin has been shown to reduce the risk of heart failure hospitalization and cardiovascular death in patients with type 2 diabetes and high cardiovascular risk 2, 4.
- The benefit of Empagliflozin on heart failure outcomes is consistent across subgroups, including patients with and without baseline heart failure, and across categories of medications to treat diabetes and/or heart failure 4.
- Empagliflozin has also been shown to improve other heart failure outcomes, including hospitalization for or death from heart failure, and is associated with a reduction in all-cause hospitalization 4.
Clinical Evidence and Potential Mechanism
- Recent evidence demonstrates that Empagliflozin brings clinical benefit to patients with established heart failure and type 2 diabetes mellitus 6.
- The potential mechanism of Empagliflozin's benefit in heart failure involves its effects on sodium-glucose cotransporter 2 inhibition, which may lead to improvements in cardiac function and reduction in hospitalizations for heart failure 6.
- Further research is needed to fully understand the relationship between Empagliflozin and right ventricular failure, as well as the potential mechanisms underlying its beneficial effects on heart failure outcomes 2, 3, 4, 5, 6.