Effect of Sodium-Glucose Cotransporter 2 Inhibitors on Left Ventricular Ejection Fraction as Add on Therapy in Treatment of Heart Failure with Low Ejection Fraction

Abstract

Objective: To compare mean left ventricular ejection fraction after treatment with sodium-glucose cotransporter 2 inhibitors versus placebo in treatment of heart failure with low ejection fraction. Study Design: Randomized controlled trial. Duration and Setting: This study was conducted from 15 May to 15 November 2025 at the Department of Medicine Khyber Teaching Hospital Peshawar. Methodology: Total 106 individuals between 40 and 70 years of age all confirmed to have heart failure with a left ventricular ejection fraction below 40% were included in the study. Participant were allocated into two arms through block randomization. One arm was treated with empagliflozin at a dose of 10 mg once daily in addition to conventional therapy where the comparison arm received a placebo alongside the same standard care. The difference in the average change in left ventricular ejection fraction between the two group was analyzed using an independent samples t-test. Results: Mean age was 61.81 ± 6.62 years in empagliflozin group and 59.49 ± 7.50 years in placebo group. ale patients constituted 66.0% and 79.2% respectively. Pre- treatment ejection fraction was 30.52 ± 3.69% in empagliflozin group and 31.98 ± 3.89% in placebo group. Post treatment values increased to 39.60 ± 4.09% and 34.98 ± 3.77% respectively. Mean improvement was significantly higher in empagliflozin group at 9.08 ± 1.92% compared to 2.99 ± 1.27% in placebo group (p < 0.001). Conclusion: Adding empagliflozin to routine treatment significantly increased left ventricular ejection fraction in patients suffering from heart failure with low ejection fraction.

Keywords: Cardiac output, Empagliflozin, Heart failure, Left ventricular function, Sodium-glucose cotransporter-2 inhibitors