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Does dapagliflozin regress left ventricular hypertrophy in patients with type 2 diabetes? A prospective,

Alexander J M Brown1, Chim Lang2, Rory McCrimmon3

  • 1Cardiovascular Medicine, Division of Molecular and Clinical Medicine, Medical Research Institute, Ninewells Hospital and Medical School, Mailbox 2, Dundee, DD1 9SY, UK.

BMC Cardiovascular Disorders
|August 25, 2017
PubMed
Abstract

Insights

Sodium glucose linked co-transporter type 2 (SGLT2) inhibitors may reduce cardiovascular risk in diabetic patients. The DAPA-LVH trial investigates if dapagliflozin can decrease left ventricular mass in patients with diabetes and left ventricular hypertrophy.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Patients with diabetes have a significantly higher risk of cardiovascular disease (CVD).
  • Current oral hypoglycaemic agents offer limited cardiovascular risk reduction.
  • Sodium glucose linked co-transporter type 2 (SGLT2) inhibitors show potential cardiovascular benefits, with trials like EMPA-REG demonstrating reduced mortality and heart failure hospitalisation.

Purpose of the Study:

  • To assess if the SGLT2 inhibitor dapagliflozin can regress left ventricular (LV) mass in patients with diabetes and left ventricular hypertrophy (LVH).
  • To strengthen the evidence for SGLT2 inhibitors as cardioprotective agents in diabetes management.

Main Methods:

  • Prospective, double-blind, randomised, placebo-controlled, single-centre study (DAPA-LVH trial).
  • Utilisation of cardiac and abdominal magnetic resonance imaging (MRI) and ambulatory blood pressure monitoring.
  • 1-year observation period assessing dapagliflozin 10 mg once daily versus standard care.

Main Results:

  • The primary endpoint is the change in LV mass.
  • Secondary outcomes include changes in LV volumes, blood pressure, weight, and visceral/subcutaneous fat.
  • Data collection ongoing since January 2017.

Conclusions:

  • The trial aims to determine if SGLT2 inhibitor therapy reduces LV mass in diabetic patients with LVH.
  • Positive findings would support the cardioprotective role of SGLT2 inhibitors beyond glucose lowering.
Keywords:
Cardiac MRIDiabetesLeft ventricular hypertrophyMechanistic trialSGLT2 inhibitor

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