Effect of Empagliflozin on Cardiac Remodeling in Non Diabetic Patients With Preserved Heart Failure

1. Ethical committee approval will be obtained from Ethics committee of Faculty of Pharmacy, Damanhour University.

2. All participants should agree to take part in this clinical study and will provide informed consent.

3. About 50 cardiac non diabetic patients diagnosed with heart failure with preserved ejection fraction will be recruited from Mahalla Cardiac Centre outpatient clinics and randomize them into two groups, group on empagliflozin 10 mg once daily and the second group placebo.

4. Blood samples will be collected before, and 3 months after intiation of the trial for evaluating Complete blood count (CBC), Serum creatinine (SCr), Aspartate aminotransferase (AST), Alanine transaminase(ALT), Hemoglobin A1C and two biomarkers which are: Human N-Terminal Pro Brain Natriuretic Peptide (NT-ProBNP) and soluble suppressor of tumorigenicity 2 (sST2) values in both groups.

5. Echocardiogram will be assessed for the patients before and 3 months after the initiation of study and the values of :

6. Left ventricular end systolic volume index (LVESI)

7. Left atrial volume index (LAVI)

8. Left ventricular mass index (LVMI)

9. Ejection fraction (EF)

10. Left atrium size

11. Grade of diastolic dysfunction

12. Cardiac output (C.O.P)

13. Stroke volume (SV)

Method:

- All participants will be randomly divided into two groups: group (A) for empagliflozin (n=25), group (B) for placebo (n=25)

Sample sizes of 50 cardiac patients (25 empagliflozin group and 25 placebo group), achieves 90% power to detect a difference (7.5 ml/m2) in the mean change of Left ventricular end systolic volume index (LVESI) between the 2 groups, using independent t test, at a 0.05 significance level.