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[Music] hello this is tom luscher talking to brian holliday at the royal brompton hospital and today we would like to uh discuss specifically a recent paper presented at the european society of cardiology this year by stefan unker and milton packer the emperor preserved trial uh on ampergliflozin in heart failure was a preserved ejection fraction welcome brian thanks very much so uh we all learned that this sodium glucose transport inhibitors are highly effective in heart failure but so far it was mainly in patients with heart failure with reduced ejection fraction that these drugs were tested directly now this new trial tries to do this in preserved ejection fraction which in their specific case meant that the ejection fraction would be higher than 40 percent so uh according to the new asc guidelines this is both ref the tongue breaker that now is renamed as a ejection fraction a mildly heart failure is mildly reduced ejection fraction and true have path above 50 percent so lets bri