Effects of empagliflozin on cardiac function

Background: Heart failure and diabetes are diseases with extremely high prevalence in Spain, what implies a high economic cost for the health system and a great loss of quality-adjusted life years. So far, any antidiabetic drug had shown a clear decline in hospitalizations due to heart failure (neither in cardiac mortality). Empagliflozin surprisingly demonstrated these results in the EMPA-REG study, it has led to its recommendation by the European and American Guidelines for diabetic patients with high cardiovascular risk. Despite this, little is known about the mechanism by which it is achieved, and about which patients can benefit more from this drug. Objectives: The main aim is to determine if Empagliflozin produces changes in cardiac function that may justify its cardiovascular benefit in heart failure. Thus, we intend to achieve the improvement in the optimization of this treatment. Design: A quasi-experimental, prospective, pre-post, longitudinal follow-up, open without a control group, in which each patient will be their own control. It will be carried out in Hospital Santa Caterina of Girona between November 2017 and February 2021. Participants: Patients between 18 and 85 years old, with poor control of type 2 Diabetes Mellitus and heart failure, who are in follow-up in the cardiology consultations of Hospital Santa Caterina. Method: A non-probabilistic consecutive sampling will be used in this study; we will evaluate cardiac function through echocardiographic parameters and evolution of heart failure though NT-proBNP value