Effects of dapagliflozin on myocardial motion parameters and cardiac electrophysiology in patients with type 2 diabetes Mellitus and coronary heart disease

Background Type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) often coexist and exacerbate cardiac dysfunction. This study aimed to evaluate the effects of dapagliflozin on myocardial motion parameters and cardiac electrophysiology in patients with T2DM and CHD. Methods This retrospective study included 262 patients with T2DM and CHD admitted between January 2021 and January 2025. Patients were assigned to either a conventional treatment group ( n = 137; standard CHD therapy plus metformin) or a dapagliflozin group ( n = 125; standard CHD therapy, metformin, and dapagliflozin 10 mg daily), with both groups treated for 4 weeks. Assessments included echocardiographic cardiac function, myocardial motion parameters, left ventricular pressure-strain loop (LV-PSL) indices, electrophysiological activity, exercise tolerance, and adverse cardiovascular events. Results Baseline characteristics were comparable between groups. The dapagliflozin group demonstrated superior clinical efficacy (93.60% vs. 76.64%, P < 0.001) and greater improvements in left ventricular ejection fraction, myocardial strain and work indices, and exercise tolerance (all P < 0.01). Dapagliflozin was also associated with enhanced cardiac electrophysiological activity, including longer QT and Tp-Te intervals and reduced ST depression (all P < 0.01). Adverse event rates did not differ significantly between groups. Conclusion In patients with T2DM and CHD, adding dapagliflozin to conventional therapy improved cardiac function, myocardial performance, electrophysiological parameters, and exercise tolerance without increasing adverse cardiovascular events.