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. 2022 May 23;11(10):2935.
doi: 10.3390/jcm11102935.

Dapagliflozin Impact on the Exercise Capacity of Non-Diabetic Heart Failure with Reduced Ejection Fraction Patients

João Reis  1 , Ana Rita Teixeira  1 , António Valentim Gonçalves  1 , Rita Ilhão Moreira  1 , Tiago Pereira Silva  1 , Ana Teresa Timóteo  1 , Rui Cruz Ferreira  1
Affiliations

Dapagliflozin Impact on the Exercise Capacity of Non-Diabetic Heart Failure with Reduced Ejection Fraction Patients

João Reis et al. J Clin Med. .

Abstract

Background: Dapagliflozin has been shown to reduce morbidity and mortality in Heart Failure with reduced Ejection Fraction (HFrEF), but its impact on exercise capacity of non-diabetic HF outpatients is unknown. Methods: Adult non-diabetic HF patients with a left ventricular ejection fraction (LVEF) <50% were randomized 1:1 to receive dapagliflozin 10 mg or to continue with HF medication. Patients underwent an initial evaluation which was repeated after 6 months. The variation of several clinical parameters was compared, with the primary endpoint being the 6 month peak oxygen uptake (pVO2) variation. Results: A total of 40 patients were included (mean age 61 ± 13 years, 82.5% male, mean LVEF 34 ± 5%), half being randomized to dapagliflozin, with no significant baseline differences between groups. The reported drug compliance was 100%, with no major safety events. No statistically significant difference in HF events was found (p = 0.609). There was a 24% reduction in the number of patients in New York Heart Association (NYHA) class III in the treatment group as opposed to a 15.8% increase in the control group (p = 0.004). Patients under dapagliflozin had a greater improvement in pVO2 (3.1 vs. 0.1 mL/kg/min, p = 0.030) and a greater reduction in NT-proBNP levels (−217.6 vs. 650.3 pg/mL, p = 0.007). Conclusion: Dapagliflozin was associated with a significant improvement in cardiopulmonary fitness at 6 months follow-up in non-diabetic HFrEF patients.

Keywords: Heart Failure with reduced Ejection Fraction; cardiopulmonary exercise test; heart failure; peak oxygen uptake; sodium–glucose co-transporter 2 inhibitors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design and population selection.
Figure 2
Figure 2
Primary endpoint—peak oxygen uptake variation from baseline to 6 months follow-up.
Figure 3
Figure 3
Comparison of CPET parameters variation between baseline and 6 month follow-up.
Figure 4
Figure 4
Comparison of echocardiographic parameters variation between baseline and 6 months follow-up.
See this image and copyright information in PMC

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