Impact of Ertugliflozin on Cardiac Structure and Function in Patients with ICDs/CRT-Ds Assessed by Echocardiography: A Post Hoc Sub-Analysis of the ERASe Trial

Background/Objectives: Ertugliflozin showed a beneficial effect to reduce arrhythmic burden in heart failure patients with an ejection fraction less than 50% with an implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy device (CRT-D) in the ERASe trial. The aim of the post hoc sub-analysis of the ERASe trial was to compare the effect of ertugliflozin versus placebo on structural and functional parameters assessed by echocardiography. Methods: In this sub-analysis of the ERASe trial, 40 patients (87% of the overall ERASe trial cohort) with stored echocardiography loops and adequate image quality were included. A post hoc analysis including structural and functional echocardiography parameters was performed by a trained investigator blinded to the treatment group. Results: After 52 weeks of treatment, there were no between-group differences in left and right ventricular dimensions (left ventricular end-diastolic and -systolic volumes, right ventricular diameter) and function (left ventricular ejection fraction [LVEF], tricuspid annular plane systolic excursion), after adjustment for baseline values. Lower LVEF at baseline was associated with a higher number of ventricular arrhythmias in both treatment groups. Conclusions: In this sub-analysis of the ERASe trial, treatment with ertugliflozin did not improve structural and functional parameters assessed by echocardiography after 52 weeks of treatment compared to placebo despite the significant reduction in arrhythmic burden.