SGLT2 Inhibition in Diabetes and Heart Failure

Inclusion Criteria: * Confirmed clinical diagnosis of stable HF (NYHA class II-III) on maximally tolerated HF medical regimen including angiotensin-inhibitors, beta-adrenergic blockers, and loop diuretics * Reduced left ventricular systolic function (LVEF\<50%) documented in the prior 12 months * Poorly controlled T2DM (HbA1c levels between 6.5% and 10.0%) * 18 years old and older. Exclusion Criteria: * Type I diabetes; * Type II diabetes with episodes of severe hypoglycemia \<50 mg/dl by history, frequent changes in anti-diabetic regimen class in the past 3 months or with a prior episode of diabetic ketoacidosis (any time); * Open label treatment with SGLT2 inhibitors (within the past month); * Treatment with thiazolidinedione (within the past month), which may induce volume and sodium retention; * Chronic Kidney Disease (GFR\<45 ml/kg\*min); * Uncontrolled thyroid dysfunction (TSH\<0.4\>4.5 mcIU/ml); * Pregnancy or of child-bearing potential; * Active or recent (within 2 weeks) genital/urinal infection; * Concomitant conditions or treatment which would affect completion or interpretation of the study including physical inability to walk or run on a treadmill such as decompensated HF (edema, NYHA class IV), significant ischemic heart disease, angina, arterial hypotension (BP systolic \<90 mmHg), orthostatic arterial hypotension, arterial hypertension (resting BP systolic \>160 mmHg), atrial fibrillation with rapid ventricular response, severe valvular disease, severe chronic obstructive or restrictive pulmonary disease, moderate- severe anemia (Hgb\<10 g/dl); * Abnormal BP or heart rate response, angina or ECG changes (ischemia or arrhy- thmias) occurring during baseline cardio-pulmonary exercise testing; * Chronic use of oral corticosteroids; * Inability to give informed consent.