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The impact of early administration of empagliflozin in patients with acute decompensated heart failure on clinical and structural-functional changes in the heart in the dynamics of 12 months of follow-up

Authors: Golubovskaya D.P.1, Karetnikova V.N.1 2, Barbarash O.L.1 2

Company: 1 Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
2 Kemerovo State Medical University, Kemerovo, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2025-19-3-316-328

For citation: Golubovskaya D.P., Karetnikova V.N., Barbarash O.L. The impact of early administration of empagliflozin in patients with acute decompensated heart failure on clinical and structural-functional changes in the heart in the dynamics of 12 months of follow-up. Creative Cardiology. 2025; 19 (3): 316–328 (in Russ.). DOI: 10.24022/1997-3187-2025-19-3-316-328

Received / Accepted:  20.03.2025 / 27.05.2025

Keywords: empagliflozin SGLT2 inhibitors gliflozins acute decompensation of heart failure echocardiography



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Abstract

Objective. To evaluate the effect of early administration of empagliflozin from the first day of hospitalization of patients with acute decompensated heart failure (ADHF) on the severity of heart failure (HF), structural and functional parameters of the heart 12 months after decompensation.

Material and methods. The study included 92 patients admitted to the hospital with a diagnosis of ADHF in the absence of hemodynamic instability. On the first day of hospitalization, patients were included in the study and randomized into two groups – with the addition of empagliflozin (10 and 25 mg/day) to basic therapy (n = 46) and a comparison group (n = 46). The observation period included 5 control points: the first day, days 7–12 of hospitalization, and 3, 6, and 12 months of observation after discharge from the hospital. All study participants underwent an assessment of clinical, anamnestic, laboratory, and instrumental data, as well as the dynamics of HF severity using the six-minute walk test (SMT).

Results. Three and 12 months after ADHF, most study participants (74.3% and 74.2%, respectively) taking empagliflozin corresponded to functional class I or II of chronic HF according to NYHA and covered a greater distance in the SMT. A significant decrease in the concentration of the N-terminal propeptide of natriuretic hormone was noted, reaching lower values after 3 months of treatment with empagliflozin (163 [116; 340] and 655 [460; 990] in the comparison group, p < 0.001). During the year of observation, empagliflozin therapy had a positive effect on the structural and functional parameters of the heart: improvement of systolic function and reduction of volumetric parameters of the left ventricle, inhibition of the rate of development of myocardial hypertrophy, positive changes in the size, volumetric parameters and contractile function of the right chambers of the heart, achievement of smaller volumes of both atria. Complications, adverse events and side reactions were not noted during therapy.

Conclusion. The obtained results indicate a positive long-term effect of early administration of empagliflozin from the 1st day hospitalization of patients with ADHF on the severity of clinical manifestations of heart failure and structural and functional parameters of the heart.

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About Authors

  • Darya P. Golubovskaya, Junior Researcher, Cardiologist; ORCID
  • Viktoriya N. Karetnikova, Dr. Med. Sci., Professor, Head of the Laboratory of Blood Circulation Pathology; ORCID
  • Olga L. Barbarash, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director, Chief of Chair of Cardiology and Cardiovascular Surgery; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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