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September 3, 2026ESC Heart FailureOpen Access

Dapagliflozin linked to ~1.5% improvement in RVGLS vs standard therapy in chronic HF.

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Why the study?

Right ventricular dysfunction is an independent prognostic factor in chronic heart failure, but poor evidence exists regarding the effect of guideline-directed medical therapy on it.

Does dapagliflozin improve right ventricular function, pulmonary pressure, and coupling in patients with chronic heart failure?

Population

142 patients with chronic heart failure

Comparison

Standard HF therapy plus dapagliflozin vs standard therapy without dapagliflozin

Design

Prospective observational registry with propensity score analysis

Follow-up

6 months

Key result

Dapagliflozin was associated with improved right ventricular global longitudinal strain compared with standard therapy in patients with chronic heart failure (adjusted mean difference -1.54%, P<0.001).

Authors

APAlberto PalazzuoliGRGaetano RuoccoSFSara Franceschi

Discussion

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Overview

May indicate RV benefit from dapagliflozin in chronic HF; hypothesis-generating and should not change practice pending RCTs.

Key Points

  • To evaluate whether dapagliflozin improves right ventricular function, right ventricular–pulmonary arterial coupling, and pulmonary artery systolic pressure compared with standard therapy in chronic heart failure.
  • Evaluated 142 chronic heart failure patients allocated to standard therapy plus dapagliflozin (n=71) or standard therapy alone (n=71) with a 6-month follow-up (ClinicalTrials.gov: NCT06002321).
  • Assessed echocardiographic right ventricular measures (RVEDD, TAPSE, RVGLS, FAC, S', PASP, TAPSE/PASP) alongside secondary outcomes including NT-proBNP and 180-day combined adverse events.
  • Dapagliflozin significantly improved right ventricular function compared with controls over 6 months, including TAPSE (+1.03 mm, p < 0.001), S' (+0.48 cm/s, p = 0.006), RVGLS (adjusted mean difference −1.54%, p < 0.001), and TAPSE/PASP ratio (0.67 vs 0.51, p < 0.001).
  • Patients receiving dapagliflozin experienced a significantly lower rate of 180-day combined mortality and hospitalization compared with controls (8% vs 21%, p < 0.01) and a significant reduction in NT-proBNP levels (938 to 726 pg/ml, p = 0.013).

Study Design

Type

Observational (n=142)

Structured PICO

Does dapagliflozin improve right ventricular function, pulmonary pressure, and coupling in patients with chronic heart failure?

P
Population
142 patients with chronic heart failure, median age 78, 38% female, followed for 6 months.
E
Exposure
Standard heart failure therapy plus dapagliflozin for 6 months
C
Comparator
Standard heart failure therapy without dapagliflozin
O
Outcome
Intra and inter-groups changes from baseline to 6 months in right ventricular end diastolic diameter (RVEDD), tricuspid annular peak systolic excursion (TAPSE), RV global longitudinal strain (RVGLS), fractional area changes (FAC), RV systolic tissue doppler wave (S’), PASP values, TAPSE/PASP, and tricuspid regurgitation (TR)surrogate

Main Result

Mean Difference: -1.54

p-value: p=<0.001

In a real-world chronic heart failure cohort, the addition of dapagliflozin to standard therapy was associated with significant improvements in right ventricular function, pulmonary pressures, and RV-PA coupling at 6 months.

Cite This Study

Palazzuoli et al. (2026) conducted an observational in Chronic heart failure (n=142). Dapagliflozin vs. Standard heart failure therapy without dapagliflozin was evaluated on Right ventricular global longitudinal strain (RVGLS) change from baseline to 6 months (adjusted mean difference -1.54%, p=<0.001). Dapagliflozin was associated with improved right ventricular global longitudinal strain compared with standard therapy in patients with chronic heart failure (adjusted mean difference -1.54%, P<0.001).

synapsesocial.com/papers/6a993511636c6408cfa7ce4chttps://doi.org/10.1093/eschf/xvag230
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