Empagliflozin has favourable effect on frontal plane QRS‐T angle in diabetic patients with cardiovascular disease

Abstract

What is Known and Objective: Empagliflozin treatment is significantly associated with lower risk of cardiovascular events in patients with diabetes mellitus (DM) independent of its antihyperglycemic effect. However, little is known regarding the impact of empagliflozin on electrocardiography (ECG) parameters. This study aimed to investigate whether empagliflozin has favourable effect on frontal plane QRS-T (fQRST) angle, which is an ECG sign of ventricular repolarization heterogeneity, in patients with type 2 DM.Methods: We prospectively enrolled 111 patients with known diagnosis of type 2 DM who newly prescribed empagliflozin on top of their standard anti-diabetic therapy. Patients were divided into two groups according to presence or absence of cardiovascular disease (CVD) at baseline and followed-up for 6 months. The impact of empagliflozin treatment on fQRST angle was investigated and patient groups were compared regarding the pre-and post-treatment fQRST angle.Results and Discussion: Among 111 patients, 32 (28.8%) had CVD and 79 (71.2%) had no CVD. Empagliflozin treatment lead a significant decrease in the mean fQRST angle throughout the study period and mean fQRST angle was significantly lower at 3-and 6-month follow-up visits compared to baseline values (62 ± 17.4 vs. 57.2 ± 14.8 vs. 50.5 ± 13.6 , p < 0.001 for all dual comparisons). However, despite similar antihyperglycemic effect with empagliflozin treatment in patients with and without CVD, the significant decrease in the mean fQRST angle was observed only in patients with CVD and no significant decrease was observed in the mean fQRST angle in patients without CVD.What is New and Conclusion: Empagliflozin leads a significant narrowing in the fQRST angle in type 2 DM patients with known CVD.

Potential favorable action of sodium-glucose cotransporter-2 inhibitors on sudden cardiac death: a brief overview

“…Indeed, the degree of improvement in ventricular repolarization heterogeneity was shown to be associated with the degree of reduction of elevated blood pressure (58) or weight loss (59). Furthermore, an abnormal QRS-T angle, another index of ventricular repolarization heterogeneity and a predictor for SCD (63), has been reported to be improved by SGLT2 inhibitors in patients with type 2 diabetes mellitus with known cardiovascular diseases (64). Taken together, the results of studies indicate that SGLT2 inhibitors may improve impaired indices of ventricular repolarization heterogeneity, but whether similar results are observed in patients with heart failure or chronic kidney disease in the absence of diabetes mellitus requires further investigation.…”