ISSN 2996-8215
International Journal of Cardiology | Vol. 17, No. 9, August 2026 | pp. 9–16
DOI: 10.46882/2026/IJC/100002
Clinical Investigation
Title: Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Right Ventricular Function in Heart Failure with Preserved Ejection Fraction
Names of Authors: Maria L. Gomez¹, Ahmed H. Al-Mansoor², Sanjay P. Patel³
Authors’ Affiliations: ¹Cardiovascular Division, Hospital Clinic de Barcelona, Barcelona, Spain; ²Department of Cardiology, King Faisal Specialist Hospital, Riyadh, Saudi Arabia; ³Department of Medicine, Duke University, Durham, NC, USA
Abstract: Background: Right ventricular (RV) dysfunction heavily influences clinical outcomes in heart failure with preserved ejection fraction (HFpEF). We investigated whether empagliflozin improves RV longitudinal strain over 6 months. Methods: In an open-label prospective trial, 115 HFpEF patients (left ventricular ejection fraction ≥ 50%, mean pulmonary arterial pressure > 20 mmHg) received empagliflozin 10 mg daily alongside standard care. Echocardiographic parameters, including RV free wall longitudinal strain (RVFWLS), were assessed at baseline and 6 months. Results: After 6 months of therapy, RVFWLS improved significantly from -16.2 ± 3.1% to -19.4 ± 3.5% (p < 0.001). Estimated pulmonary artery systolic pressure decreased from 42 ± 9 mmHg to 35 ± 7 mmHg (p = 0.002). Improvements in functional capacity evaluated via the 6-minute walk test increased by an average of 42 ± 15 meters (p < 0.001). NT-proBNP levels declined by 28% from baseline. Conclusion: Treatment with empagliflozin leads to measurable improvements in RV systolic function and hemodynamic load in patients with HFpEF.
Keywords: Heart failure, SGLT2 inhibitors, Right ventricular function, Echocardiography, Hemodynamics
Manuscript Timeline: Received 02 May 2026; Revised 01 June 2026; Accepted 20 June 2026; Published 15 August 2026
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