Dapagliflozin Improves Measures of Left Ventricular Function in T2DM Patients

A prospective trial of patients with type 2 diabetes mellitus and stable heart failure found that 5 mg/day of dapagliflozin improved mitral flow, left ventricular mass index, and left atrial volume index after 6 months of treatment.

“The objective of this study was to investigate the impact of sodium glucose cotransporter type 2 (SGLT2) inhibitors on left ventricular (LV) diastolic function of type 2 diabetes mellitus (T2DM) patients with heart failure (HF),” wrote investigators Fumitaka Soga, MD, Hidekazu Tanaka, MD, PhD, Kazuhiro Tatsumi, MD, PhD, et al, from Kobe University Graduate School of Medicine, Kobe, Japan.

The research was presented at the American College of Cardiology’s (ACC) 68^th Annual Scientific Session in New Orleans.

The study included 58 patients with T2DM and stable heart failure at 5 medical centers in Japan. Participants had previously been taking at least 1 antidiabetic drug other than SGLT2 inhibitors before starting the dapagliflozin 5 mg/day regimen. Data were collected for each participant at baseline and after 6 months of receiving daily dapagliflozin.

The study met its primary endpoint of the change in mitral inflow E and mitral e’ annular velocities (E/e’) between baseline and 6 months. E/e’ decreased significantly after 6 months, from 9.3 cm/s to 8.5 cm/s (P = .020).

The study’s secondary endpoints included a change in brain natriuretic peptide (BNP), LV mass index (LVMI) and left atrial volume index (LAVI).

After 6 months, LAVI significantly decreased from 31 mL/m² to 26 mL/m² (P = .001). LVMI did as well from 75.0 g/m² to 67.0 g/m² (P <.001).

No significant change in BNP was observed—it went from 27.9 pg/mL to 28.9 pg/mL (P = .132). However, among patients with BNP ≥100pg/mL, the study reported a significant decrease in BNP from 168.8 pg/mL to 114.3 pg/mL (P = .012).

The investigators concluded that the trial “may offer a new insight into the management of T2DM patients with HF.”

The poster, “Effect of Dapagliflozin on Left Ventricular Diastolic Function of Patients With Type 2 Diabetic Mellitus With Chronic Heart Failure,” was presented at the ACC Annual Scientific Session on Saturday, March 16, 2019.