Discussion
diabetes, T2D, LVH, g/mReductions
ACUTE MI, HEART FAILURE, LVH, DIABETES
In this exploratory sub-analysis of the EMPA-HEART CardioLink-6 trial, we evaluated the influence of baseline LVMi on cardiac reverse remodelling with empagliflozin. Our analysis yielded the key finding that patients with a baseline LVMi > 60 g/mReductions in LVM are associated with cardiovascular risk reduction and improved clinical outcomes [A post hoc subgroup analysis of the EMPA-REG OUTCOME trial demonstrated that risk reduction of 3-point MACE with empagliflozin was greater in patients who had LVH at baseline when compared those without [In a recent meta-analysis of RCTs using cMRI to examine SGLT2i-mediated cardiac reverse remodelling in patients with T2D and/or heart failure, treatment with an SGLT2i was associated with a significant reduction in LVM [This study provides important and valuable information regarding the role of empagliflozin in cardiac reverse remodelling in patients with diabetes, however it must be noted that the current study also has limitations. First, the sample size was small. Second, the participants in this study were only followed for 6 months and it has been shown that, at least after an acute MI, LV remodelling can continue for as long as 2 years. Third, given the nature of this analysis, the findings should be considered hypothesis-generating.