Key result
Dapagliflozin significantly decreased right ventricular systolic pressure and left ventricular filling pressure during exercise at 6 months in patients with type 2 diabetes and cardiovascular risk.
Why the study?
It was unclear whether an SGLT2-i improves LV pump function and suppresses elevation of LVFP and RVSP during exercise in T2DM patients.
Does dapagliflozin improve ventricular hemodynamics and exercise-induced pulmonary hypertension in patients with type 2 diabetes mellitus and cardiovascular risk?
RCT (n=78)
Open-label
Computer-based dynamic allocation method
Yes
Does dapagliflozin improve ventricular hemodynamics and exercise-induced pulmonary hypertension in patients with type 2 diabetes mellitus and cardiovascular risk?
p-value: p=<0.001
Dapagliflozin significantly improves right ventricular systolic pressure and left ventricular filling pressure during exercise in patients with T2DM, providing a potential mechanistic basis for its benefits in heart failure.
May reduce exercise ventricular pressures in T2D; hypothesis-generating for HF prevention, needs RCT confirmation.
BACKGROUND: This prospective randomized multicenter open-label trial evaluated whether sodium-glucose cotransporter-2 inhibitor (SGLT2-i) improves left ventricular (LV) pump function and suppresses elevation of LV filling pressure (LVFP) and right ventricular systolic pressure (RVSP) during exercise in type 2 diabetes mellitus (T2DM) patients. METHODS AND RESULTS: ). Both RVSP and LVFP during exercise significantly decreased from baseline to 6 months after starting treatment in the D-group (P<0.001). No changes to either parameter was observed in the C-group. The SVi and CI did not improve in either group. Both home and office blood pressure significantly decreased in the D-group. Decreases in HbA1c were somewhat greater in the C-group. CONCLUSIONS: Dapagliflozin significantly improved RVSP and LVFP during exercise in patients with T2DM and cardiovascular risk, which may contribute to favorable effects on heart failure.
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Kayano et al. (2020) conducted an RCT in Type 2 diabetes mellitus with cardiovascular risk (n=78). Dapagliflozin vs. Conventional therapy add-on (excluding SGLT2 inhibitors) was evaluated on Change in right ventricular systolic pressure (RVSP) during exercise from baseline to 6 months (p=<0.001). Dapagliflozin significantly decreased right ventricular systolic pressure and left ventricular filling pressure during exercise at 6 months in patients with type 2 diabetes and cardiovascular risk.
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