About this trial
This study will test whether pharmacologic agents that may improve mitochondrial function and energy fuel metabolism \[Empagliflozin (Empa)\], with and without additional supplements that increase perfusion and fatty acid oxidation \[Potassium Nitrate (KNO3)\], improve submaximal exercise endurance and skeletal muscle oxidative phosphorylation capacity (SkM OxPhos) in participants with Heart Failure with Preserved Ejection Fraction (HFpEF).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
Age <18 years old
Pregnancy: Women of childbearing potential will undergo a urine pregnancy test during the screening visit.
Treatment with organic nitrates or phosphodiesterase inhibitors that cannot be interrupted
Uncontrolled atrial fibrillation, as defined by a resting atrial fibrillation heart rate > 100 beats per minute at the time of the baseline assessment
Trial design
Crossover
Treatments tested in this trial
Empagliflozin + Potassium Chloride
DrugEmpagliflozin is the active intervention that may improve mitochondrial function and energy fuel metabolism in skeletal muscle. KCl is an active control.
Empagliflozin + Potassium Nitrate
DrugEmpagliflozin + KNO3 is the active intervention that may improve mitochondrial function and energy fuel metabolism in skeletal muscle, as well as increase skeletal muscle perfusion during exercise.
Potassium Chloride + Placebo for Empagliflozin
DrugActive control.
Treatment groups
Trial outcomes
Primary outcomes
Submaximal Exercise Endurance
Time to exhaustion while exercising at 75% peak workload
Secondary outcomes
Intramuscular Perfusion
MRI assessment of skeletal muscle perfusion
VO2 Kinetics
Assess the impact of interventions on the kinetics of oxygen consumption (VO2 kinetics) during exercise and recovery. "On" and "Off" kinetics will be modeled during the submaximal exercise transient.
VO2 Efficiency
Assess the impact of interventions on the efficiency of oxygen consumed above basal metabolic rate compared to total work performed
Vasodilatory Reserve
Percent change in systemic vascular resistance (SVR) at baseline vs SVR at 4 minutes of exercise at end of each intervention period
Other outcomes
Intramyocardial Filling Pressure
Assess impact of interventions on intramyocardial filling pressures during submaximal exercise
Sponsors and contacts
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