Multiparametric evaluation of the effects of dapagliflozin in patients with heart failure and reduced ejection fraction.

BACKGROUND AND AIMS: Sodium-glucose transporter 2 inhibitors have recently shown promise as a therapy to reduce mortality and hospitalisation for heart failure (HF) in patients with and without type 2 diabetes mellitus. The aim of this prospective study was to determine the results of a multiparametric evaluation after the addition of dapagliflozin to standard therapy in patients with heart failure with reduced ejection fraction (HFrEF).

METHODS

From February to November 2022, 45 patients with chronic HF who regularly visited our HF outpatient clinic were selected for this study. Exclusion criteria were severe chronic renal insufficiency (GFR < 25 ml/min), type 1 diabetes, hypertrophic or restrictive cardiomyopathy, active myocarditis, constrictive pericarditis. The included patients took dapagliflozin once daily in addition to sacubitril/valsartan and other HF drugs. The following parameters were recorded before the start of therapy and at the 3-month follow-up: NYHA functional class, characteristics of the cardiopulmonary exercise test (CPET), parameters of the six-minute walk test (6MWT), quality of life (QoL) using the Kansas City Cardiomyopathy Questionnaire (KCCQ), echocardiographic evaluation.

RESULTS

At 3-month follow-up, a significant increase in peak Vo2 (from 17.5 to 18.2, p < 0.001) and a significant decrease in VE/VCO2 (35.2 to 33.1, p = 0.011) were observed. In addition, Vo2/work gradient and pulse O2 increased significantly. Furthermore, a significant improvement in 6MWT, quality of life and left ventricular dimensions and systolic function was observed.

CONCLUSION

This prospective, multiparametric study showed that the additional administration of dapaglifozin to sacubitril/valsartan and other HF drugs is effective after three months.