Abstract: TH-PO0329
Effect of Empagliflozin on Echocardiographic Parameters of Diastolic Function in ESKD: A Pilot/Feasibility Study
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Crasta, Nicholas, The University of Mississippi Medical Center, Jackson, Mississippi, United States
- Tio, Maria Clarissa, The University of Mississippi Medical Center, Jackson, Mississippi, United States
- Yen, Timothy E., The University of Mississippi Medical Center, Jackson, Mississippi, United States
- Wells, Catherine C., The University of Mississippi Medical Center, Jackson, Mississippi, United States
- Hall, Michael E., The University of Mississippi Medical Center, Jackson, Mississippi, United States
- Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Dossabhoy, Neville R., The University of Mississippi Medical Center, Jackson, Mississippi, United States
- Shafi, Tariq, Baylor Scott & White Medical Center Temple, Temple, Texas, United States
- Obi, Yoshitsugu, The University of Mississippi Medical Center, Jackson, Mississippi, United States
Background
SGLT2 inhibitors (SGLT2i) are recommended for heart failure, yet robust data on their safety and efficacy are limited in patients with ESKD on dialysis. Given emerging evidence of direct cardiac benefits from SGLT2i, we previously reported improvements in systolic function following a 3-month course of empagliflozin in this population. Here, we evaluated changes in echocardiographic diastolic function parameters after empagliflozin treatment in ESKD patients on dialysis.
Methods
In this prospective, non-randomized pilot/feasibility study, transthoracic echocardiograms were performed at baseline and after 3 months of empagliflozin treatment (10 mg daily or 25 mg thrice weekly) in adult patients with ESKD receiving dialysis. Assessed diastolic function parameters included diastolic dysfunction grade, longitudinal strain, tissue Doppler velocities (e’), E/e’ ratio, mitral inflow E/A ratio, left atrial volume index, and tricuspid regurgitation max velocity. Paired t-tests or Wilcoxon signed-rank tests were used for continuous variables, and Fisher’s exact test for changes in diastolic dysfunction grade.
Results
Seven patients (mean age 58 ± 8 years; 71% male) completed the study. While most diastolic parameters showed favorable trends, many did not reach statistical significance. The mean septal E/e’ ratio decreased from 17.8 ± 7.5 to 14.7 ± 5.0 (p=0.12), and the average E/e’ ratio decreased from 18.1 ± 7.7 to 12.7 ± 2.1 (p=0.21). Lateral e’ velocity showed a mean improvement of +0.84 cm/s (p=0.20). Notably, peak mitral E-wave velocity significantly decreased from a median (IQR) of 1.1 (0.9-1.3) m/s to 0.9 (0.7-1.0) m/s (Wilcoxon p=0.02), suggesting improved LV filling dynamics.
Conclusion
Three months of empagliflozin treatment in ESKD patients on dialysis was associated with improvements in peak mitral E-wave velocity. Despite the small sample size limiting statistical power for most outcomes, the consistency of these trends and the significant reduction in peak E-wave velocity suggest potential diastolic benefits. These preliminary findings warrant larger, randomized controlled trials to definitively assess the impact of SGLT2i on long-term cardiovascular outcomes in the dialysis population.
Funding
- Other NIH Support