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

American Heart Association Introduces New Post-acute Care Heart Failure Certification
News | Heart Failure | July 03, 2019
The new Post-Acute Care Heart Failure Certification offered from the American Heart Association (AHA) provides...
Novel Therapeutic Approach Effective at Reducing Pressure for Heart Failure Patients

Image courtesy of Kapur N.K., Karas R.H., Burkhoff D., et al.

News | Heart Failure | June 17, 2019
Results from a first-in-man proof of concept study found occlusion of the superior vena cava (SVC) rapidly and...
Tafamidis meglumine (Vyndaqel) is one of two new drugs cleared by the FDA for the treatment of the cardiomyopathy caused by transthyretin mediated amyloidosis (ATTR-CM) in adults. These are the first FDA-approved treatments for ATTR-CM. U.S. Food and Drug Administration (FDA) approved tafamidis meglumine (Vyndaqel) and tafamidis (Vyndamax) capsules for the treatment of the cardiomyopathy.

Tafamidis meglumine (Vyndaqel) is one of two new drugs cleared by the FDA for the treatment of the cardiomyopathy caused by transthyretin mediated amyloidosis (ATTR-CM) in adults. These are the first FDA-approved treatments for ATTR-CM. 

Technology | Heart Failure | May 06, 2019
May 6, 2019 — The U.S.
The Aortic intra-aortic axial flow pump is designed to unload the heart and increase renal perfusion in heart failure patients experiencing cardiorenal syndrome.

The Aortic intra-aortic axial flow pump is designed to unload the heart and increase renal perfusion in heart failure patients experiencing cardiorenal syndrome.

Feature | Heart Failure | April 29, 2019 | Will Clifton, M.D.
The heart and kidneys are inextricably linked through a diverse web of hemodynamic, neural and hormonal mechanisms.
Diabetes Drug Effective Against Heart Failure in Wide Spectrum of Patients
News | Heart Failure | March 29, 2019
The cardiovascular benefits of the diabetes drug dapagliflozin extend across a wide spectrum of patients and are...
New data from a four-week extension of the landmark PIONEER-HF Trial showed the drug sacubitril/valsartan (Entresto) continued to deliver reductions in the heart failure biomarker N-terminal pro–B-type natriuretic peptide (NT-proBNP), an established biomarker for heart failure severity and prognosis.[1] The data was presented as a late-breaker at the American College of Cardiology (ACC) 2019 Annual Scientific Session in March.
News | Heart Failure | March 27, 2019
March 27, 2019 —New data from a four-week extension of the landmark PIONEER-HF Trial showed the drug sacubitril/valsa
Toilet Seat Detects Congestive Heart Failure

Nicholas Conn, a postdoctoral fellow at RIT and founder and CEO of Heart Health Intelligence, is part of the university team that has developed a toilet-seat based cardiovascular monitoring system. Image courtesy of A. Sue Weisler/RIT.

News | Heart Failure | March 26, 2019
March 26, 2019 — A toilet seat-based ...
FDA Approves Optimizer Smart System for Heart Failure Patients offers cardiac contractility modulation.
Technology | Heart Failure | March 21, 2019
The U.S. Food and Drug Administration (FDA) approved Impulse Dynamics’ Optimizer Smart system for treating patients...
William T. Abraham, M.D., Joins V-Wave as Chief Medical Officer

William T. Abraham, M.D., in an interview with DAIC Editor Dave Fornell at TCT 2016.

News | Heart Failure | March 12, 2019
V-Wave Ltd. announced that renowned heart failure cardiologist William T. Abraham, M.D., is joining V-Wave as chief...
Overlay Init