Diabetes medicine can reverse heart failure

Newly developed antidiabetic drug enfluflosin can cure and reverse the development of heart failure in non-diabetic animal models, according to new research published in Journal of the American Academy of Cardiology. Their study also shows that this medicine can make the heart produce more energy and work more efficiently.

"This drug could be a promising treatment for heart failure in both non-diabetic and diabetic patients," said lead author of the study Juan Badimon. "Our research can lead to possible human application, save lives and improve the quality of life."

Emagliflozin restricts renal sugar uptake and is the first drug in the history of type 2 diabetes that has been shown to prolong survival. While patients with diabetes are usually at a higher risk of heart failure, older studies have shown that those taking emagliflozin do not often develop heart failure. These observations led a team of researchers to question whether the drug contains a mechanism independent of antidiabetic activity associated with the prevention of heart failure and could have the same impact on non-diabetics.

Researchers at the Atherothrombosis Research Unit investigated the case causing heart failure in 14 non-diabetic pigs. For two months, they received half of the animals with ambagliflozin and the other group with placebo. The team evaluated the pigs with cardiac magnetic resonance imaging, 3D echocardiography, and invasive catheterization at three different study sites (pre-induction, one day after challenge and two-month sign). At two months, all animals in the group treated with entafloflosin showed improved cardiac function. Specifically, these pigs had less accumulation of water in the lungs (less pulmonary congestion, which is responsible for causing dyspnoea) and lower levels of biomarkers of heart failure. Importantly, the left ventricles had stronger contractions (enhanced systolic function), became smaller (less dilated) and were less viscous (less hypertrophy) and the heart was normal (less architectural remodeling).

The researchers also found that the drug treated heart failure by improving cardiac metabolism. Pig hearts in the drug consume more fatty acids and ketones (three related compounds – acetone, acetoacetic acid and? -Hydroxybutyric acid produced during fat metabolism) and less glucose compared to patients with cardiac insufficiency and , whose hearts consume more glucose and virtually no fatty acids and produce less energy. This boost in metabolism has helped the hearts produce more energy and function more vigorously and efficiently.

The authors are currently investigating whether entaflozosin is an effective treatment of heart failure in non-diabetic people in the EMPATROPISM clinical trial.