{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T03:52:21Z","timestamp":1776829941756,"version":"3.51.2"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The EMPERIAL (Effect of EMPagliflozin on ExeRcise ability and HF symptoms In patients with chronic heArt faiLure) trials evaluated the effects of empagliflozin on exercise ability and patient-reported outcomes in heart failure (HF) with reduced and preserved ejection fraction (EF), with and without type 2 diabetes (T2D), reporting, for the first time, the effects of sodium-glucose co-transporter-2 inhibition in HF with preserved EF (HFpEF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>HF patients with reduced EF (HFrEF) (\u226440%, N = 312, EMPERIAL-Reduced) or preserved EF (&amp;gt;40%, N = 315, EMPERIAL-Preserved), with and without T2D, were randomized to empagliflozin 10 mg or placebo for 12 weeks. The primary endpoint was 6-minute walk test distance (6MWTD) change to Week 12. Key secondary endpoints included Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS) and Chronic Heart Failure Questionnaire Self-Administered Standardized format (CHQ-SAS) dyspnoea score. 6MWTD median (95% confidence interval) differences, empagliflozin vs. placebo, at Week 12 were \u22124.0 m (\u221216.0, 6.0; P = 0.42) and 4.0 m (\u22125.0, 13.0; P = 0.37) in EMPERIAL-Reduced and EMPERIAL-Preserved, respectively. As the primary endpoint was non-significant, all secondary endpoints were considered exploratory. Changes in KCCQ-TSS and CHQ-SAS dyspnoea score were non-significant. Improvements with empagliflozin in exploratory pre-specified analyses of\u00a0KCCQ-TSS responder rates, congestion score, and diuretic use in EMPERIAL-Reduced are hypothesis generating. Empagliflozin adverse events were consistent with those previously reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The primary outcome for both trials was neutral. Empagliflozin was well tolerated in HF patients, with and without T2D, with a safety profile consistent with that previously reported in T2D. Hypothesis-generating improvements in exploratory analyses of secondary endpoints with empagliflozin in HFrEF were observed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaa943","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T20:17:47Z","timestamp":1604607467000},"page":"700-710","source":"Crossref","is-referenced-by-count":199,"title":["Effect of empagliflozin on exercise ability and symptoms in heart failure patients with reduced and preserved ejection fraction, with and without type 2 diabetes"],"prefix":"10.1093","volume":"42","author":[{"given":"William T","family":"Abraham","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, The Ohio State University , 473 West 12th Ave., Columbus, OH 43210, USA"}]},{"given":"JoAnn","family":"Lindenfeld","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center , 1211 Medical Center Drive, Nashville, TN 37232, USA"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Wroclaw Medical University , Wybrze\u017ce L. Pasteura 1, 50-367, Wroclaw, Poland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8345-6382","authenticated-orcid":false,"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino-IRCCS , Via Carlo Parea, 4 \u2013 20138, Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19 20122, Milan , Italy"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Mississippi Medical Center , 2500 N. State Street, Jackson, MS-39216, USA"}]},{"given":"Akshay S","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School , 75 Francis Street, Boston, MA 02115, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":false,"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, School of Medicine , Athens 157 72, Greece"},{"name":"University of Cyprus, School of Medicine , Shacolas Educational Centre for Clinical Medicine, Palaios dromos Lefkosias Lemesou No.215\/6, 2029 Aglantzia, Nicosia, Cyprus"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7150-0801","authenticated-orcid":false,"given":"Jacek","family":"Gniot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Independent Public Healthcare , General Hospital in Pu\u0142awy; ul. Bema 1; 24 \u2013 100 Pulawy, Poland"}]},{"given":"Michael","family":"Fu","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital\/\u00d6stra Hospital, Gothenburg University , Bl\u00e5 str\u00e5ket 5, 413 45 Gothenburg, Sweden"}]},{"given":"Lars","family":"Gullestad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital , Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo , S\u00f8sterhjemmet, Kirkeveien 166, 2.etasje, 0450 Oslo, Norway"},{"name":"KG Jebsen Center for Cardiac Research, University of Oslo , Sogn Arena, Klaus Torg\u00e5rds vei 3, 2. Etg, 0372 Oslo, Norway"},{"name":"Center for Heart Failure Research, Department of Cardiology Medicine (Building 3), 1st floor, Oslo University Hospital, Kirkeveien 166, 0407 \u00a0Oslo, Norway"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0535-9771","authenticated-orcid":false,"given":"Jonathan G","family":"Howlett","sequence":"additional","affiliation":[{"name":"Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary , 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada"}]},{"given":"Stephen J","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Monash University , 27 Rainforest Walk, Clayton VIC 3800, Melbourne, Australia"}]},{"given":"Josep","family":"Redon","sequence":"additional","affiliation":[{"name":"INCLIVA Research Institute, University of Valencia , vinguda de Men\u00e9ndez y Pelayo, 4, 46010 Valencia, and CIBERObn, Madrid, Spain"}]},{"given":"Isabelle","family":"Schenkenberger","sequence":"additional","affiliation":[{"name":"Klinische Forschung Berlin GbR , Ansbacher Str. 17-19, 10787 Berlin, Germany"}]},{"given":"Jos\u00e9","family":"Silva-Cardoso","sequence":"additional","affiliation":[{"name":"CardioCare, CINTESIS\u2014Center for Health Technology and Services Research, and Director of the Cardiology Service, Porto University Medical School , S\u00e3o Jo\u00e3o University Medical Centre, Rua Dr. Pl\u00e1cido da Costa, s\/n 4200-450, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1771-7249","authenticated-orcid":false,"given":"Stefan","family":"St\u00f6rk","sequence":"additional","affiliation":[{"name":"Department of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, W\u00fcrzburg University and University Hospital W\u00fcrzburg , Straubm\u00fchlweg 2, 97078 W\u00fcrzburg, Germany"}]},{"given":"Jerzy","family":"Krzysztof Wranicz","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Medical University of Lodz , al. 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