What does this research mean for the field?

Adding dapagliflozin to standard medical therapy improves exercise capacity, quality of life, and left ventricular systolic function within three months in patients with heart failure and reduced ejection fraction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 28, 2025Acta cardiologica. Supplementum

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

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Why the study?

Sodium-glucose transporter 2 inhibitors reduce mortality and HF hospitalization, but the effects of adding dapagliflozin across a multiparametric evaluation in HFrEF warranted prospective determination.

Does the addition of dapagliflozin to standard therapy improve functional capacity, quality of life, and echocardiographic parameters in patients with HFrEF?

Structured PICO

Does the addition of dapagliflozin to standard therapy improve functional capacity, quality of life, and echocardiographic parameters in patients with HFrEF?

Population

45 patients with chronic heart failure with reduced ejection fraction (HFrEF) from an outpatient clinic. Exclusion criteria: severe chronic renal insufficiency (GFR < 25 ml/min), type 1 diabetes, hypertrophic or restrictive cardiomyopathy, active myocarditis, constrictive pericarditis.

Intervention

Dapagliflozin once daily added to sacubitril/valsartan and other standard HF drugs.

Comparator

Baseline parameters before the start of therapy (single-arm pre-post comparison).

Outcome

Multiparametric evaluation including NYHA functional class, cardiopulmonary exercise test (CPET) characteristics, six-minute walk test (6MWT) parameters, quality of life (KCCQ), and echocardiographic evaluation at 3-month follow-up.surrogate

The addition of dapagliflozin to standard HFrEF therapy, including sacubitril/valsartan, significantly improves functional capacity, quality of life, and left ventricular systolic function at 3 months.

Implication

Dapagliflozin addition was associated with improved exercise parameters in HFrEF; leaves open need for larger prospective trials.

Abstract

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: = 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.