Empagliflozin for heart failure with preserved ejection fraction: targeting cardiac endothelial cell-cardiomyocyte interaction

Background: Heart failure with preserved ejection fraction (HFpEF) accounts for 50% of HF cases. A new paradigm of HFpEF suggests a systemic low-grade pro-inflammatory state leading to cardiac microvascular dysfunction and subsequent impairment of cardiac diastolic function. EMPA-REG trial’s positive findings on HF outcome suggest a direct beneficial effect of a sodium-glucose co-transporter 2 inhibitor, empagliflozin, on the heart.