Moreover, empagliflozin led to significant reductions in left atrial diameter, left ventricular end-systolic and end-diastolic volumes, NT-proBNP levels, blood pressure, heart rate, stroke work, myocardial oxygen consumption, estimated by rate pressure product, and an increase in ejection fraction, myocardial mechano-energetic efficiency, red blood cells, hematocrit, and hemoglobin levels compared to glimepiride. ResultsĪs compared with glimepiride, treatment with empagliflozin resulted in a greater reduction in myocardial glucose metabolic rate from baseline to 26 weeks (adjusted difference -6.07 μmol/min/100g, (-8.59, -3.55), P<0.0001). We also measured cardiac geometry, myocardial mechano-energetic efficiency, and systolic and diastolic function by echocardiography. To further investigate the cardioprotective mechanism of SGLT2i we performed a 26-week, randomized, open-label, cross-over, active-comparator study to determine the effects of empagliflozin 10 mg versus glimepiride 2 mg daily on myocardial glucose metabolic rate assessed by cardiac dynamic 18F-FDG-PET combined with a euglycemic-hyperinsulinemic clamp in 23 patients with type 2 diabetes. ![]() The primary aim of this study was to determine whether treatment with empagliflozin was able to affect myocardial glucose metabolic rate, assessed by cardiac dynamic 18F-FDG-PET combined with a euglycemic-hyperinsulinemic clamp compared to glimepiride in patients with type 2 diabetes.
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