Physicians' Academy for Cardiovascular Education

SGLT2i reduces patient-reported HF symptom burden in HFrEF

News - June 30, 2020

Patient-reported outcomes with empagliflozin in the EMPERIAL trials

HFA Discoveries 2020 webinar presented by Prof. JoAnn Lindenfeld (Nashville, US)

Introduction and methods

SGLT2 inhibitors have been shown to improve symptoms in patients with HFrEF as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ). The effects of empagliflozin in patients with HF, with or without T2DM on patient-reported outcomes and 6-minute walking test distance have been investigated in two EMPERIAL trials.

In the EMPERIAL-reduced (LVEF ≤40%, n=312) and EMPERIAL-preserved (LVEF >40%, n=315) trials, patients were randomized (1:1) to receive either empagliflozin 10 mg qd or placebo for 12 weeks. In the current analyses, KCCQ - Total Symptom Score (KCCQ-TSS) and Chronic Heart Failure Questionnaire-Self-Administered Standardized Format (CHQ-SAS) were used to measure patient-reported outcomes at baseline and week 12. The primary endpoint for both EMPERIAL-reduced and EMPERIAL-preserved was neutral, therefore all results are considered exploratory.

Main results

improved in favor of empagliflozin in the EMPERIAL-reduced trial. This was mostly due to improvements in symptom frequency, symptom burden and social limitations sub-domains.


Analyses of HF symptoms measured by KCCQ-TSS suggest a trend towards reductions in HF symptom burden with empagliflozin compared to placebo in patients with HFrEF. A trend towards improvements in burden of fatigue and dyspnea, measured by CHQ-SAS, with empagliflozin was also observed in HFrEF patients. No treatment effects on KCCQ-TSS and CHQ-SAS were observed in patients with HFpEF.

-Our reporting is based on the information provided by the HFA Discoveries webinar -

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