News | Heart Failure | April 19, 2019

Diabetes Drug May Reverse Heart Failure

Mount Sinai study finds drug could have new applications in non-diabetics

Diabetes Drug May Reverse Heart Failure

April 19, 2019 – Researchers at the Icahn School of Medicine at Mount Sinai have demonstrated that the recently developed antidiabetic drug empagliflozin can treat and reverse the progression of heart failure in non-diabetic animal models. Their study also shows that this drug can make the heart produce more energy and function more efficiently. The results were published in the April 23 issue of the Journal of the American College of Cardiology.1

“This drug could be a promising treatment for heart failure in both non-diabetic and diabetic patients,” said lead author Juan Badimon, M.D., professor of cardiology and director of the Atherothrombosis Research Unit at the Cardiovascular Institute at the Icahn School of Medicine at Mount Sinai. “Our research can lead to a potential application in humans, save lives and improve quality of life.”

Empagliflozin was approved by the U.S. Food and Drug Administration (FDA) in 2014. It limits renal sugar resorption and is the first drug in the history of type 2 diabetes proven to prolong survival. While diabetes patients are typically at higher risk of heart failure, past studies have suggested that those who take empagliflozin do not commonly develop heart failure. Those observations led a team of researchers to question if the drug contains a mechanism, independent of anti-diabetic activity, that is linked to heart failure prevention, and whether it could have the same impact on non-diabetics.

Investigators from the Atherothrombosis Research Unit tested the hypothesis by inducing heart failure in 14 non-diabetic pigs. For two months, they treated half of the animals with empagliflozin and the other group with a placebo. The team evaluated the pigs with cardiac magnetic resonance, 3-D echocardiography and invasive catheterization at three different points in the study (before inducing, one day after inducing and at the two-month mark). At two months, all animals in the group treated with empagliflozin experienced improved heart function. Specifically, those pigs had less water accumulation in the lungs (less pulmonary congestion, which is responsible for causing shortness of breath) and lower levels of biomarkers of heart failure. Importantly, the left ventricles had stronger contractions (enhanced systolic function), got smaller (less dilated) and were less thick (less hypertrophy), and the heart was a normal shape (less architectural remodeling).

The researchers also found that the drug addressed heart failure by improving cardiac metabolism. The hearts of pigs on the medication were consuming more fatty acids and ketone bodies (three related compounds — acetone, acetoacetic acid and beta-hydroxybutyric acid — produced during the metabolism of fats) and less glucose, as contrasted with heart failure patients (diabetic and non-diabetic), whose hearts consume more glucose and almost no fatty acids and produces less energy. This boost in metabolism helped the hearts produce more energy and function more strongly and efficiently.

“This study confirmed our hypothesis that empagliflozin is an incredibly effective treatment for heart failure and not only an antidiabetic drug. Moreover, this study demonstrated that empagliflozin is useful for heart failure independently of a patient’s diabetic status. Importantly, empagliflozin switches cardiac metabolism toward fatty acid and ketone body consumption, thus allowing the production of more energy in the heart,” explained co-lead author Carlos Santos-Gallego, M.D., postdoctoral fellow at the Icahn School of Medicine at Mount Sinai. “Empagliflozin may be a potentially effective treatment for heart failure patients. This is extremely important because heart failure is a disease with a mortality above 50 percent at five years. This study offers a new therapeutic strategy in heart failure, something badly needed given that there have not been new effective drugs for heart failure since the 1990s.”

The authors are currently studying whether empagliflozin is an effective heart failure treatment in non-diabetic human patients in the EMPATROPISM clinical trial.

For more information: www.onlinejacc.org

 

Reference

1. Santos-Gallego C.G., Requena-Ibanez J.A., San Antonio R., et al. Empagliflozin Ameliorates Adverse Left Ventricular Remodeling in Nondiabetic Heart Failure by Enhancing Myocardial Energetics. Journal of the American College of Cardiology, April 23, 2019. DOI: 10.1016/j.jacc.2019.01.056

Related Content

FDA Grants Fast Track Designation for Farxiga in Heart Failure
News | Heart Failure | September 18, 2019
AstraZeneca announced the U.S. Food and Drug Administration (FDA) has granted Fast Track designation for the...
Corvia Medical and physIQ Partner in Global Phase 3 Heart Failure Device Clinical Trial

The REDUCE LAP HF-II study will combine Corvia Medical's InterAtrial Shunt Device (IASD), pictured here, with physIQ's continuous monitoring platform to evaluate the device's efficacy in patients with heart failure. Image courtesy of Corvia Medical.

News | Heart Failure | September 12, 2019
Corvia Medical has sponsored and is actively enrolling patients in a heart failure (HF) device trial that, in addition...
 Tiny Wearable Cameras May Improve Quality of Life in Heart Failure Patients

Image courtesy of Amazon.com

News | Heart Failure | September 11, 2019
The ever-present devices that seem to track all our moves can be annoying, intrusive or worse, but for heart failure...
PARAGON-HF Misses Endpoint in Preserved Heart Failure
News | Heart Failure | September 11, 2019
The angiotensin neprilysin inhibitor sacubitril/valsartan (Entresto) missed its primary endpoint of reducing total...
Farxiga Significantly Reduces Cardiovascular Death and Worsening of Heart Failure
News | Heart Failure | September 09, 2019
AstraZeneca announced detailed results from the landmark Phase III DAPA-HF trial that showed Farxiga (dapagliflozin) on...
Dapagliflozin, Forxiga, was found to help improve outcomes in heart failure patients with reduced ejection fraction (HFrEF) at ESC 2019. #ESC19 #ESC2019
News | Heart Failure | September 09, 2019
September 9, 2019 — The drug Dapagliflozin was found to reduce death and hospitalization in patients who have heart f
Entresto Improved Measures of Heart Structure and Function in Heart Failure Patients
News | Heart Failure | September 04, 2019
September 4, 2019 – Novartis announced results from two new...
FDA Approves Barostim Neo System for Advanced Heart Failure Patients. Similar to a pacemaker, the Barostim Neo System uses a pulse generator implanted below the collar bone with a lead that attaches to the carotid artery in the neck. It delivers electrical impulses to baroreceptors in the neck, which sense how blood is flowing through the carotid arteries and relays information to the brain. The brain, in turn, sends signals to the heart and blood vessels that relax the blood vessels.

Similar to a pacemaker, the Barostim Neo System uses a pulse generator implanted below the collar bone with a lead that attaches to the carotid artery in the neck. It delivers electrical impulses to baroreceptors in the neck, which sense how blood is flowing through the carotid arteries and relays information to the brain. The brain, in turn, sends signals to the heart and blood vessels that relax the blood vessels and inhibit the production of stress-related hormones to reduce heart failure symptoms.

Technology | Heart Failure | August 19, 2019
The U.S. Food and Drug Administration (FDA) approved the Barostim Neo System for the improvement of symptoms in...
Ancora Heart Enrolls First Patient in European Multi-center Study of AccuCinch Heart Failure Therapy
News | Heart Failure | August 14, 2019
Ancora Heart Inc. announced the first patient was enrolled in the CorCinch EU study, a European multi-center clinical...
Procyrion Receives FDA Breakthrough Device Designation for Aortix System
Technology | Heart Failure | July 30, 2019
Procyrion Inc. secured Breakthrough Device designation by the U.S. Food and Drug Administration (FDA) for its Aortix...
Overlay Init