Empagliflozin modulates renal sympathetic and heart rate baroreflexes in a rabbit model of diabetes

Cindy Gueguen, Sandra L. Burke, Benjamin Barzel, Nina Eikelis, Anna M.D. Watson, Jay C. Jha, Kristy L. Jackson, Yusuke Sata, Kyungjoon Lim, Gavin W. Lambert, Karin A.M. Jandeleit-Dahm, Mark E. Cooper, Merlin C. Thomas, Geoffrey A. Head

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Abstract

Aims/hypothesis: We determined whether empagliflozin altered renal sympathetic nerve activity (RSNA) and baroreflexes in a diabetes model in conscious rabbits. Methods: Diabetes was induced by alloxan, and RSNA, mean arterial pressure (MAP) and heart rate were measured before and after 1 week of treatment with empagliflozin, insulin, the diuretic acetazolamide or the ACE inhibitor perindopril, or no treatment, in conscious rabbits. Results: Four weeks after alloxan administration, blood glucose was threefold and MAP 9% higher than non-diabetic controls (p < 0.05). One week of treatment with empagliflozin produced a stable fall in blood glucose (−43%) and increased water intake (+49%) but did not change RSNA, MAP or heart rate compared with untreated diabetic rabbits. The maximum RSNA to hypotension was augmented by 75% (p < 0.01) in diabetic rabbits but the heart rate baroreflex was unaltered. Empagliflozin and acetazolamide reduced the augmentation of the RSNA baroreflex (p < 0.05) to be similar to the non-diabetic group. Noradrenaline (norepinephrine) spillover was similar in untreated diabetic and non-diabetic rabbits but twofold greater in empagliflozin- and acetazolamide-treated rabbits (p < 0.05). Conclusions/interpretation: As empagliflozin can restore diabetes-induced augmented sympathetic reflexes, this may be beneficial in diabetic patients. A similar action of the diuretic acetazolamide suggests that the mechanism may involve increased sodium and water excretion. [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)1424–1434
Number of pages11
JournalDiabetologia
Volume63
Issue number7
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Baroreflex
  • Diabetes
  • Empagliflozin
  • Perindopril
  • Renal sympathetic nerve activity
  • SGLT2 inhibitor

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