Research
Hormonal
SGLT2 inhibitors improve heart failure outcomes through mechanisms independent of glucose lowering, including natriuresis, osmotic diuresis, reduced plasma volume, and improved myocardial energetics via ketone utilization.
SGLT2 inhibitors help the heart by making it work more efficiently. They help remove excess fluid and sodium, reducing strain on the heart, and shift the heart's fuel source to ketones, which are more energy-efficient. This happens regardless of blood sugar levels.
ModerateSupportsMEDIUM confidence
While the exact mechanism by which empagliflozin may impact HF outcomes is not understood, several effects of SGLT2 inhibitors may be of benefit... SGLT2 inhibitors induce osmotic diuresis and natriuresis... The elevated level of beta hydroxybutyrate seen with SGLT2 inhibitors results in a shift in fuel supply... towards the more energy-efficient ketones.
Why this rating
Based on physiological explanations and animal models, with some human data supporting hemodynamic changes.
Source
Moderated ePoster Session 2
Javed Butler et al. · European Journal of Heart Failure · 2014
DOI 10.1002/ejhf.933
narrative_reviewCited 162×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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