Effect of Empagliflozin on Left Atrial Function in Adults at Risk for Heart Failure

Inclusion criteria

• Age >60 years of age
• Clinical diagnosis of hypertension
• Body mass index ≥30kg/m2
• We will screen for participants with an echocardiogram within 60 days of the baseline visit

Exclusion criteria

• Female participants who are pregnant, lactating, or of child bearing potential
• History of type 1 or type 2 diabetes mellitus by medical history or hemoglobin A1c >7.0% at Visit 1
• Clinical diagnosis of HFpEF or HFrEF by participant self-report or documented in the electronic health record
• Any LVEF measure of ≤40% on past echocardiogram
• Moderate or severe valve disease on echocardiogram
• History of genitourinary infection
• eGFR <60 ml/min/1.73 m2 at Visit 1
• Current treatment with SGLT2 inhibitor, GLP1 agonist, or DPP4 inhibitors
• Participants in whom coronary revascularization by either PCI or bypass surgery is being contemplated within 6 months, or who have undergone revascularization in the prior 2 months
• Significant allergy or known intolerance to SGLT2 inhibitors or any ingredient in the formulations
• Participants currently experiencing any clinically significant or unstable medical condition that might limit their ability to complete the study, or to comply with the requirements of the protocol, including: dermatologic disease, hematological disease, pulmonary disease, hepatic disease, gastrointestinal disease, genitourinary disease, endocrine disease, neurological disease, and psychiatric disease
• Any malignancy not considered cured (except basal cell carcinoma of the skin). A participant is considered cured if there has been no evidence of cancer recurrence for the 5 years prior to screening
• Participants who have participated in studies of an investigational drug or device within 30 days prior to the screening visit
• Inadequate quality echocardiographic images
• Unstable coronary syndromes
• Major surgery (major according to the investigator's assessment) performed within 90 days prior to Visit 1 or scheduled major elective surgery within 90 days after Visit 1.
• Non-English speaking individuals