NCT06782139

Effects of Enavogliflozin on Coronary Microvascular and Cardiac Function in Obesity

Effects of ENavogliflozin on Coronary microVascular and Cardiac Function in Patients With obesitY (ENVY)

• Status: Recruiting
• Phase: Phase 4
• Study type: Interventional
• Enrollment: 30 (estimated)
• Sponsor: Korea University Anam Hospital · Academic / Other
• Sex: All
• Age: 20 Years – 79 Years
• Healthy volunteers: Not accepted

Summary

The goal of this study is to analyze the effects of enavogliflozin on heart function and coronary microvascular function in obese patients compared to a placebo, and to evaluate the improvement in cardiopulmonary exercise capacity in these patients.

Detailed description

In recent years, the prevalence of obesity has increased, which acts as a significant risk factor for cardiovascular diseases. Obesity is closely related to reduced microvascular function, increased insulin resistance, and elevated blood pressure, and it is particularly known to be a major cause of heart failure with preserved ejection fraction (HFpEF) and diastolic dysfunction. Coronary microvascular dysfunction (CMD) leads to angina, myocardial infarction, and heart failure, which are associated with increased mortality. CMD has recently gained more importance as one of the key mechanisms of HFpEF. However, CMD often shows poor response to standard treatments, and when not recognized by healthcare providers, it can result in poor outcomes due to a lack of appropriate treatment. Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors are drugs that inhibit glucose reabsorption by blocking SGLT2 in the proximal tubules of the kidneys, thereby lowering blood sugar. Initially developed as oral hypoglycemic agents, previous randomized controlled studies have shown that they also have significant beneficial effects on heart failure and cardiovascular diseases not only in diabetic patients but also in non-diabetic patients. Recent studies have also demonstrated the effectiveness of SGLT2 inhibitors in patients with HFpEF. SGLT2 inhibitors reduce excessive sodium excretion through urine, which reduces fluid volume, lowers blood pressure, and decreases body weight, but the exact mechanism of their significant effects in cardiovascular diseases is still not fully understood. In particular, research on the effects of SGLT2 inhibitors on microvascular function is still limited. Recently, a randomized controlled study involving 16 diabetic patients reported an increase in myocardial flow reserve after 4 weeks of dapagliflozin administration, while another study involving 90 high-risk cardiovascular diabetic patients showed no significant change in myocardial flow reserve at 13 weeks with empagliflozin. Regarding enavogliflozin, a recent animal study in pigs suggested that it could improve vascular function by intervening in coronary endothelial cell function. This study hypothesized that enavogliflozin would improve microvascular abnormalities and enhance heart function and cardiopulmonary exercise capacity in obesity-related cardiovascular diseases. Therefore, the objective of this study is to analyze the effects of enavogliflozin on heart function and microvascular function in obese patients compared to a placebo, and to evaluate the improvement in cardiopulmonary exercise capacity in these patients.

Conditions

• Obesity and Type 2 Diabetes

Interventions

Type	Name	Description
DRUG	Enavogliflozin	Patients who are enrolled in the study will undergo adenosine stress tests assessing coronary flow velocity reserve and body composition analysis on the day of registration. Within 2 weeks, cardiopulmonary exercise tests will be performed with exhalation gas analysis. After completing the baseline cardiopulmonary exercise capacity evaluation, patients will be assigned to either the enavogliflozin or placebo group and monitored for adverse effects within one month. Patients without significant adverse effects will continue the assigned treatment, and at 12 weeks, they will undergo re-evaluation of coronary flow velocity reserve, body composition analysis, and cardiopulmonary exercise capacity. Adverse events will be monitored from the date of enrollment through the final evaluation.
DRUG	Placebo	Patients who are enrolled in the study will undergo adenosine stress tests assessing coronary flow velocity reserve and body composition analysis on the day of registration. Within 2 weeks, cardiopulmonary exercise tests will be performed with exhalation gas analysis. After completing the baseline cardiopulmonary exercise capacity evaluation, patients will be assigned to either the enavogliflozin or placebo group and monitored for adverse effects within one month. Patients without significant adverse effects will continue the assigned treatment, and at 12 weeks, they will undergo re-evaluation of coronary flow velocity reserve, body composition analysis, and cardiopulmonary exercise capacity. Adverse events will be monitored from the date of enrollment through the final evaluation.

Timeline

• Start date: 2025-01-20
• Primary completion: 2025-12-31
• Completion: 2025-12-31
• First posted: 2025-01-17
• Last updated: 2025-09-02

Locations

1 site across 1 country: South Korea