Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Strohhofer, C.
The Impact of the SGLT Inhibitor Empagliflozin on the Left Atrial Function after Acute Myocardial Infarction - the EMMY-Trial
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 65
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Benedikt Martin
- von Lewinski Dirk
- Altmetrics:
- Abstract:
- Background and Aim: Clinical trials showed that sodium–glucose co-transporter 2 inhibitors (SGLT2i) lead to better outcomes in patients with symptomatic heart failure compared to placebo. The EMMY-trial confirmed this result after acute myocardial infarction (AMI) by a significant decrease of N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP) with Empagliflozin. This thesis aims to give a better insight into the involvement of the left atrium (LA) as part of the myocardial systolic and diastolic dysfunction. Material and Methods: The echocardiographic loops of 219 patients after AMI, who received standard treatment plus Placebo or standard treatment plus Empagliflozin within the framework of the EMMY-trial, were assessed at three points in time (week 0, 6±2 und 26±2) regarding left atrial structure and function. The resulting data was statistically compared over time and between the groups in a triple-blind approach. Correlation analyses with other laboratory (e.g. NT-proBNP) and echocardiographic markers (e.g. left ventricular ejection fraction) were conducted. Results: The measured echocardiographic left atrial structural and functional parameters did not significantly differ between the intervention and placebo group at any time. Over time both groups demonstrated a significant increase in left atrial global longitudinal strain (LA GLS) (p = .000) and left atrial volume index (LAVI) (p = .000). LA GLS correlated strongly with left atrial circumferential strain (LA GCS) (ρ = .622), moderately with left atrial ejection fraction (LA EF) (ρ = .435), left ventricular ejection fraction (LVEF) (ρ = .320) and NT-proBNP (ρ = - .372), as well as weakly with LAVI (ρ = - .221). Conclusion: Empagliflozin did not result in a significant improvement of echocardiographic left atrial strain and volume parameters compared to placebo. However, after 26 weeks, a significant increase of LA GLS and LAVI became evident in both groups. Since there was only a weak correlation between LAVI and LA GLS, further clinical research of strain parameters is needed to get a better understanding of the left atrial role in different cardiac conditions.