{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:44:17Z","timestamp":1791341057409,"version":"4.3.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2019,11,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>SGLT2 (sodium-glucose cotransporter 2) inhibitors lower cardiovascular events in type 2 diabetes mellitus but whether they promote direct cardiac effects remains unknown. We sought to determine if empagliflozin causes a decrease in left ventricular (LV) mass in people with type 2 diabetes mellitus and coronary artery disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Between November 2016 and April 2018, we recruited 97 individuals \u226540 and \u226480 years old with glycated hemoglobin 6.5% to 10.0%, known coronary artery disease, and estimated glomerular filtration rate \u226560mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      . The participants were randomized to empagliflozin (10 mg\/day, n=49) or placebo (n=48) for 6 months, in addition to standard of care. The primary outcome was the 6-month change in LV mass indexed to body surface area from baseline as measured by cardiac magnetic resonance imaging. Other measures included 6-month changes in LV end-diastolic and -systolic volumes indexed to body surface area, ejection fraction, 24-hour ambulatory blood pressure, hematocrit, and NT-proBNP (N-terminal pro b-type natriuretic peptide).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among the 97 participants (90 men [93%], mean [standard deviation] age 62.8 [9.0] years, type 2 diabetes mellitus duration 11.0 [8.2] years, estimated glomerular filtration rate 88.4 [16.9] mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      , LV mass indexed to body surface area 60.7 [11.9] g\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), 90 had evaluable imaging at follow-up. Mean LV mass indexed to body surface area regression over 6 months was 2.6 g\/m\n                      <jats:sup>2<\/jats:sup>\n                      and 0.01 g\/m\n                      <jats:sup>2<\/jats:sup>\n                      for those assigned empagliflozin and placebo, respectively (adjusted difference \u22123.35 g\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI, \u22125.9 to \u22120.81g\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      =0.01). In the empagliflozin-allocated group, there was significant lowering of overall ambulatory systolic blood pressure (adjusted difference \u22126.8mmHg, 95% CI \u221211.2 to \u22122.3mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      =0.003), diastolic blood pressure (adjusted difference \u22123.2mmHg; 95% CI, \u22125.8 to \u22120.6mmHg,\n                      <jats:italic>P<\/jats:italic>\n                      =0.02) and elevation of hematocrit (\n                      <jats:italic>P<\/jats:italic>\n                      =0.0003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Among people with type 2 diabetes mellitus and coronary artery disease, SGLT2 inhibition with empagliflozin was associated with significant reduction in LV mass indexed to body surface area after 6 months, which may account in part for the beneficial cardiovascular outcomes observed in the EMPA-REG OUTCOME (BI 10773 [Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT02998970.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.119.042375","type":"journal-article","created":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T05:02:02Z","timestamp":1566450122000},"page":"1693-1702","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":524,"title":["Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease"],"prefix":"10.1161","volume":"140","author":[{"given":"Subodh","family":"Verma","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery (S.V., T.M, V.G., H.T., A.Q.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Surgery (S.V., M.A.O.), University of Toronto, Ontario, Canada."},{"name":"Department of Pharmacology and Toxicology (S.V., T.M., V.G., M.A.O.), University of Toronto, Ontario, Canada."},{"name":"Heart and Stroke Richard Lewar Centre (S.V., A.T.Y., M.E.F., K.A.C.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. David","family":"Mazer","sequence":"additional","affiliation":[{"name":"Department of Anesthesia (C.D.M.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Anesthesia (C.D.M.), University of Toronto, Ontario, Canada."},{"name":"Department of Physiology (C.D.M., K.A.C.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Yan","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.T.Y., D.H.F., S.G.G., K.A.C.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Medicine (A.T.Y., V.G., M.E.F., D.H.F., S.G.G., R.E.G., L.A.L., P.J., B.Z., K.A.C.), University of Toronto, Ontario, Canada."},{"name":"Heart and Stroke Richard Lewar Centre (S.V., A.T.Y., M.E.F., K.A.C.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamique","family":"Mason","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery (S.V., T.M, V.G., H.T., A.Q.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Pharmacology and Toxicology (S.V., T.M., V.G., M.A.O.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Garg","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery (S.V., T.M, V.G., H.T., A.Q.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Pharmacology and Toxicology (S.V., T.M., V.G., M.A.O.), University of Toronto, Ontario, Canada."},{"name":"Department of Medicine (A.T.Y., V.G., M.E.F., D.H.F., S.G.G., R.E.G., L.A.L., P.J., B.Z., K.A.C.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwee","family":"Teoh","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery (S.V., T.M, V.G., H.T., A.Q.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Division of Endocrinology and Metabolism (H.T., R.E.G., L.A.L.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Zuo","sequence":"additional","affiliation":[{"name":"Applied Health Research Centre (F.Z., P.J.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Quan","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery (S.V., T.M, V.G., H.T., A.Q.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Farkouh","sequence":"additional","affiliation":[{"name":"Department of Medicine (A.T.Y., V.G., M.E.F., D.H.F., S.G.G., R.E.G., L.A.L., P.J., B.Z., K.A.C.), University of Toronto, Ontario, Canada."},{"name":"Heart and Stroke Richard Lewar Centre (S.V., A.T.Y., M.E.F., K.A.C.), University of Toronto, Ontario, Canada."},{"name":"Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital\/Mount Sinai Hospital, Ontario, Canada (M.E.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Fitchett","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.T.Y., D.H.F., S.G.G., K.A.C.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Medicine (A.T.Y., V.G., M.E.F., D.H.F., S.G.G., R.E.G., L.A.L., P.J., B.Z., K.A.C.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun G.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.T.Y., D.H.F., S.G.G., K.A.C.), Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital, Toronto, Ontario, Canada."},{"name":"Department of Medicine (A.T.Y., V.G., M.E.F., D.H.F., S.G.G., R.E.G., L.A.L., P.J., B.Z., K.A.C.), University of Toronto, Ontario, Canada."},{"name":"Canadian Heart Research Centre, Toronto, Ontario (S.G.G.)."},{"name":"Canadian Virtual Coordinating Centre for Global Collaborative Cardiovascular Research Centre, University of Alberta, Edmonton (S.G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald M.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"LMC Diabetes &amp; 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