Unraveling the Molecular Mechanism of Action of Empagliflozin in Heart Failure With Reduced Ejection Fraction With or Without Diabetes.

ANN, artificial neural network DM, diabetes mellitus HF, heart failure HFrEF, HF with reduced ejection fraction MI-HF, post-infarct heart failure NHE, sodium-hydrogen exchanger RNAseq, RNA sequencing SGLT2i, sodium-glucose co-transporter 2 inhibitor empagliflozin heart failure machine learning

Journal

JACC. Basic to translational science
ISSN: 2452-302X
Titre abrégé: JACC Basic Transl Sci
Pays: United States
ID NLM: 101677259

Informations de publication

Date de publication:
Nov 2019
Historique:
received: 20 05 2019
revised: 09 07 2019
accepted: 09 07 2019
entrez: 31 1 2020
pubmed: 31 1 2020
medline: 31 1 2020
Statut: epublish

Résumé

The mechanism of action of empagliflozin in heart failure with reduced ejection fraction (HFrEF) was deciphered using deep learning in silico analyses together with in vivo validation. The most robust mechanism of action involved the sodium-hydrogen exchanger (NHE)-1 co-transporter with 94.7% accuracy, which was similar for diabetics and nondiabetics. Notably, direct NHE1 blockade by empagliflozin ameliorated cardiomyocyte cell death by restoring expression of X-linked inhibitor of apoptosis (XIAP) and baculoviral IAP repeat-containing protein 5 (BIRC5). These results were independent of diabetes mellitus comorbidity, suggesting that empagliflozin may emerge as a new treatment in HFrEF.

Identifiants

pubmed: 31998851
doi: 10.1016/j.jacbts.2019.07.010
pii: S2452-302X(19)30224-4
pmc: PMC6978551
doi:

Types de publication

Journal Article

Langues

eng

Pagination

831-840

Informations de copyright

© 2019 The Authors.

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Auteurs

Oriol Iborra-Egea (O)

Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red Enfermedades Cardiovascualres (CIBERCV), Madrid, Spain.

Evelyn Santiago-Vacas (E)

Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red Enfermedades Cardiovascualres (CIBERCV), Madrid, Spain.

Salva R Yurista (SR)

Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Josep Lupón (J)

Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red Enfermedades Cardiovascualres (CIBERCV), Madrid, Spain.

Milton Packer (M)

Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas.

Stephane Heymans (S)

Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.

Faiez Zannad (F)

Centre d'Investigation Clinique Plurithématique 1433, INSERM U1116, Université de Lorraine, Centre Hospitalier Régional et Universitaire de Nancy, French Clinical Research Infrastructure Network (F-CRIN), Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists (INI-CRCT), Nancy, France.

Javed Butler (J)

Department of Medicine, University of Mississippi, Jackson, Mississippi.

Domingo Pascual-Figal (D)

Domingo Hospital Universitario Virgen de la Arrixaca, University of Murcia, Centro Nacional de Investigaciones Cardiovasculares, CIBERCV, Murcia, Spain.

Antonio Lax (A)

Domingo Hospital Universitario Virgen de la Arrixaca, University of Murcia, Centro Nacional de Investigaciones Cardiovasculares, CIBERCV, Murcia, Spain.

Julio Núñez (J)

Cardiology Department, Hospital Clínico Universitario, CIBERCV, INCLIVA, Universitat de València, València, Spain.

Rudolf A de Boer (RA)

Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Antoni Bayés-Genís (A)

Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red Enfermedades Cardiovascualres (CIBERCV), Madrid, Spain.

Classifications MeSH