The main purpose of this study is to observe outcomes of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in heart failure (HF) patients with left ventricular assist devices (LVAD).
The exact mechanism of cardiovascular benefit from SGLT2i continues to be the source of further research. The investigators hypothesize that heart failure patients with LVADs will similarly benefit from the SGLT2i-associated natriuresis and diuresis, which in turn reduces preload. This is further associated with reduced heart failure readmissions and right ventricular failure. Additionally, the animal models indicating reduced cardiac work and remodeling in this population may benefit these patients as one of the goals of LVAD implantation is to reduce cardiac energy expenditure and promote remodeling and recovery in these patients. This is a prospective, randomized controlled study to assess cardiac benefit of SGLT2i in 40 consecutive patients with heart failure undergoing LVAD implantation. After routine LVAD implantation, patients will be randomized 1:1 to one of two routine care arms: management with an SGLT2i \[empagliflozin 10 milligram (mg) daily or dapagliflozin 10 mg daily, based on formulary coverage\] or no SGLT2i. The patient's treating physician will be able to override randomization assignment if they determine that the assignment is not in the patient's best interest. SGLT2i management (if applicable) and follow-up care will be dictated by routine care. Data will be collected from the subject's medical record for 6 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
University of Chicago
Chicago, Illinois, United States
Change in Left Ventricular End-diastolic Dimension (LVEDD)
Time frame: 6 months after pre-LVAD
Weight Change
Time frame: 6 months after pre-LVAD
Diuretic Dose
Diuretic Dose at 6 months in PO lasix equivalents
Time frame: 6 months after pre-LVAD
LVEF (Left Ventricular Ejection Fraction)
Time frame: 6 months after pre-LVAD
RV (Normal Right Ventricular) Size
Time frame: 6 months after pre-LVAD
Creatitine
Time frame: 6 months after pre-LVAD
ALT (Alanine Aminotransferase/SGPT)
Time frame: 6 months after pre-LVAD
AST (Aspartate Aminotransferase/SGOT)
Time frame: 6 month after pre-LVAD
Total Bilirubin (Bili)
Time frame: 6 month after pre-LVAD
Alk Phos (Alkaline Phosphatase/ALP)
Time frame: 6 month after pre-LVAD
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