The effect of empagliflozin on peripheral microvascular dysfunction in patients with heart failure with preserved ejection fraction
Authors' conclusion
This study shows that three months treatment with empagliflozin changed peripheral microvascular function in patients with HFpEF. Empagliflozin may enhance microvascular blood flow specifically via vascular actions of insulin, rather than a general effect on endothelial vasoregulation or smooth muscle cell function. As such, systemic microvascular dysfunction can be a modifiable factor in patients with HFpEF, while the clinical implications thereof warrant further investigations.
Study context
- Population
- Patients diagnosed with heart failure with preserved ejection fraction (HFpEF) eligible for empagliflozin; mean age 74 ± 7 years, 62% female26 completed per protocol
- Comparison
- Empagliflozin 10 mg daily for 3 months: follow-up vs baseline
- Outcome
- Difference in forearm microvascular blood flow (cutaneous vascular conductance, CVC) by laser speckle contrast analysis during iontophoresis of acetylcholine, insulin, sodium nitroprusside
- Follow-up
- Baseline to 3 months
Main finding
As reported in the abstract
CVC response · 3 months
- Response to sodium nitroprusside remained stable after 3 months
- 3 months vs Baseline: P < 0.001
- 3 months vs Baseline: P = 0.03
Further findings
Quality of life (EQ-5D-5 L)
- No significant correlations between changes in blood flow and quality of life
Original publication
The effect of empagliflozin on peripheral microvascular dysfunction in patients with heart failure with preserved ejection fraction. Cardiovasc Diabetol. Published 25 April 2025. doi:10.
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