EMPA-VISION Trial: Insights into Empagliflozin's Impact on Cardiac Physiology

A study called EMPA-VISION investigated whether treatment with empagliflozin, a sodium-glucose co-transporter 2 inhibitor (SGLT2i), could improve myocardial energetics, serum metabolomics, and cardiorespiratory fitness in patients with heart failure with reduced or preserved ejection fraction. The study enrolled 72 patients and was randomized, double-blind, and placebo-controlled. The primary endpoint was a change in the cardiac phosphocreatine: ATP ratio (PCr:ATP) from baseline to week 12. The study found that empagliflozin treatment did not improve cardiac energetics or change circulating serum metabolites associated with energy metabolism. Based on these results, the study suggests that enhancing cardiac energy metabolism is unlikely to mediate the beneficial effects of SGLT2i in heart failure.