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Researchers at the Icahn School of Medicine at Mount Sinai have demonstrated that newly developed antidiabetic empagliflozin can treat and reverse the progression of heart failure in non-diabetic animal models. Their study also shows that this drug can make the heart produce more energy and function more efficiently. The results were published in the April 23rd issue of the Journal of the American College of Cardiology.
"This medication may be a promising treatment for heart failure in diabetic and non-diabetic patients," said lead author Dr. Juan Badimon, a professor of cardiology and director of the Atherotrombose Research Unit at the Cardiovascular Institute of the Faculty of Medicine of Icahn. Mount Sinai. "Our research can lead to potential human application, saving lives and improving quality of life."
Empagliflozin has been approved by the US Food and Drug Administration in 2014. It limits renal sugar reabsorption and is the first drug in the history of type 2 diabetes that demonstrates prolonged survival. Although patients with diabetes are generally at increased risk of heart failure, previous studies have suggested that those taking empagliflozine generally do not develop heart failure. These observations led a team of researchers to question whether the drug contains a mechanism, independent of the antidiabetic activity that is linked to the prevention of heart failure, and whether it could have the same impact on non-diabetics.
Researchers at the Athertrombosis Research Unit tested the hypothesis by inducing heart failure in 14 non-diabetic pigs. For two months, they treated half the animals with empagliflozin and the other group with a placebo. The team evaluated pigs with cardiac magnetic resonance imaging, 3D echocardiography and invasive catheterization at three different points in the study (before induction, one day after induction and at the two-month mark). At two months, all animals in the empagliflozin group showed improvement in cardiac function. Specifically, these pigs had less accumulation of water in the lungs (less pulmonary congestion, which is responsible for causing shortness of breath) and lower levels of biomarkers of heart failure. It is important to note that the left ventricles had stronger contractions (increased systolic function), became smaller (less dilated), less thick (less hypertrophic) and the heart was normal (less architectural remodeling).
The researchers also found that the drug addressed heart failure by improving cardiac metabolism. The hearts of the medication pigs were consuming more fatty acids and ketone bodies (three related compounds – acetone, acetoacetic acid and betahydroxybutyric acid – produced during fat metabolism) and less glucose, in contrast to patients with heart failure. (diabetic and non-diabetic), whose hearts consume more glucose and almost no fatty acid and produce less energy. This boost in metabolism has helped the hearts to produce more energy and to function more and more efficiently.
"This study confirmed our hypothesis that empagliflozin is an extremely effective treatment for heart failure and not just an antidiabetic." In addition, this study demonstrated that empagliflozin is useful for heart failure regardless of a patient's diabetes status. empagliflozin changes the cardiac metabolism ". consumption of acids and ketone bodies, thus allowing the production of more energy in the heart, "explained author co-author Carlos Santos-Gallego, MD, postdoctoral fellow at the Icahn School of Medicine at Mount Sinai." Empagliflozin may be a potentially effective for patients with heart failure. This is extremely important because heart failure is a disease with mortality above 50 percent in 5 years. This study offers a new therapeutic strategy in heart failure, something very necessary since there have been no new effective medicines for heart failure since the 1990s. "
The authors are currently studying whether empagliflozin is an effective treatment for heart failure in non-diabetic human patients in the clinical trial EMPATHROPISM.
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Mount Sinai Heart is one of the nation's 10 Best Hospitals in Cardiology / Cardiac Surgery
The Mount Sinai Health System is the largest integrated delivery system in New York City, covering eight hospitals, a major medical school, and a vast network of outpatient practices throughout the greater New York area. The vision of Mount Sinai is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the country. The Health System includes approximately 7,480 primary care and specialty physicians; 11 joint-venture outpatient surgery centers; more than 410 outpatient practices in the five districts of New York, Westchester, Long Island and Florida; and 31 affiliated community health centers. Icahn Medical School is one of three medical schools that has stood out for several indicators: ranked among the top 20 by US News & World Report's "Best Medical Schools," aligned with US News & World Report's Honor Roll Hospital, No. 12 of the country for funding from the National Institutes of Health, and among the 10 most innovative research institutions ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice and research. Mount Sinai Hospital ranks 18th in the "Honor Roll" of U.S. News & World Report of major US hospitals; is one of the 20 best hospitals in the country in Gastroenterology / General Surgery, Geriatrics, Nephrology and Neurology / Neurosurgery, and among the top 50 in six other specialties in the edition of "Best Hospitals" from 2018-2019. Mount Sinai Kravis Children's Hospital is also ranked nationally in five of ten pediatric specialties by U.S. News & World Report. Mount Sinai's New York Eye and Ear Ward is ranked 11th in the national Ophthalmology ranking and 44th in Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West and the South Nassau Communities Hospital are ranked regionally.
About the health system of Mount Sinai
The Mount Sinai Health System is the largest integrated delivery system in New York City, covering eight hospitals, a major medical school, and a vast network of outpatient practices throughout the greater New York area. The vision of Mount Sinai is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the country. The Health System includes approximately 7,480 primary care and specialty physicians; 11 joint-venture outpatient surgery centers; more than 410 outpatient practices in the five districts of New York, Westchester, Long Island and Florida; and 31 affiliated community health centers. Icahn Medical School is one of three medical schools that has stood out for several indicators: ranked among the top 20 by US News & World Report's "Best Medical Schools," aligned with US News & World Report's Honor Roll Hospital, No. 12 of the country for funding from the National Institutes of Health, and among the 10 most innovative research institutions ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice and research. Mount Sinai Hospital ranks 18th in the "Honor Roll" of U.S. News & World Report of major US hospitals; is one of the top 20 hospitals in the country in Cardiology / Cardiac Surgery, Gastroenterology / General Surgery, Geriatrics, Nephrology and Neurology / Neurosurgery, and among the top 50 in six other specialties in the "Best Hospitals" edition of 2018-2019. Mount Sinai Kravis Children's Hospital is also ranked nationally in five of ten pediatric specialties by U.S. News & World Report. Mount Sinai's New York Eye and Ear Ward is ranked 11th in the national Ophthalmology ranking and 44th in Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West and the South Nassau Communities Hospital are ranked regionally.
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