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Effect of dapagliflozin on left ventricular structure and function in patients with non-ischemic dilated
Jun Hong1, Lei Huang, Nake Jin
1Department of Cardiology, Ningbo Hangzhou Bay Hospital, Ningbo, China.
Insights
Sodium glucose cotransporter type 2 (SGLT2) inhibitors, when added to conventional therapy, significantly improve cardiac structure and function in patients with non-ischemic dilated cardiomyopathy (NIDCM). This combination therapy offers greater benefits than conventional therapy alone.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Non-ischemic dilated cardiomyopathy (NIDCM) is a serious condition characterized by enlarged left ventricles and impaired pumping function, leading to high morbidity and mortality.
- Sodium glucose cotransporter type 2 (SGLT2) inhibitors have demonstrated efficacy in reducing cardiovascular events in heart failure patients.
Purpose of the Study:
- To investigate the impact of combined administration of SGLT2 inhibitors with conventional therapy on cardiac structure and function in NIDCM patients.
- To compare the effects of dapagliflozin plus conventional therapy versus conventional therapy alone in NIDCM.
Main Methods:
- A study involving 50 newly diagnosed NIDCM patients divided into two groups: one receiving conventional therapy plus dapagliflozin (SGLT2i group, n=23) and the other receiving conventional therapy alone (non-SGLT2i group, n=27).
- Cardiac structure and function were assessed after 12 months of outpatient follow-up.
Main Results:
- Both groups showed improvements in left ventricular dimensions and function, but the SGLT2i group exhibited a greater reduction in left ventricular volumes and a more significant increase in ejection fraction and fractional shortening.
- The SGLT2i group demonstrated a greater absolute percentage fall in left ventricular volume compared to the non-SGLT2i group, leading to significantly improved cardiac function.
- Specific improvements in the non-SGLT2i group included -2.8% LVEDd, -4.6% LVESd, -6.2% LVEDV, -10.1% LVESV, -6.1% LVEDVi, -10.1% LVESVi, +9.7% FS, and +11% LVEF.
Conclusions:
- Combined administration of SGLT2 inhibitors with conventional therapy provides superior beneficial effects on left ventricular volumes and cardiac function in NIDCM patients compared to conventional therapy alone.
- SGLT2 inhibitors represent a promising therapeutic strategy for enhancing cardiac remodeling and function in NIDCM.
Abstract:
Non-ischemic dilated cardiomyopathy (NIDCM) is characterized by left ventricular dilatation and contractile dysfunction with severe morbidity and mortality. Sodium glucose cotransporter type 2 (SGLT2) inhibitors significantly reduce cardiovascular events for heart failure patients. We performed to investigate the impact of combined administration of SGLT2 inhibitors on cardiac structure and function in NIDCM patients undergoing conventional therapy. A total of 50 newly diagnosed NIDCM patients received conventional medical therapy, with 23 receiving dapagliflozin 10mg/day in addition (SGLT2i group) and the remaining 27 only receiving conventional therapy (non-SGLT2i group). After 12 months outpatient follow-up, NIDCM patients treated with conventional therapy alone showed a significant reduction of left ventricular end-diastolic dimensions (LVEDd), left ventricular end-systolic dimensions (LVESd), left ventricular end-diastolic volumes (LVEDV), left ventricular end-systolic volumes (LVESV), left ventricular end-diastolic volume index (LVEDVi) and left ventricular end-systolic volume index (LVESVi), while an increase in fractional shortening (FS) and left ventricular ejection fraction (LVEF). Patients receiving dapagliflozin combined with conventional treatment also demonstrated a significant reduction in left ventricular dimensions and volumes, and a marked increase in cardiac function. In non-SGLT2i groups, the % change in LVEDd, LVESd, LVEDV, LVESV, LVEDVi, LVESVi, FS and LVEF was -2.8%, -4.6%, -6.2%, -10.1%, -6.1%, -10.1%, +9.7%, +11%. A greater absolute % fall in left ventricular volume in SGLT2i groups compared to non-SGLT2i groups resulted in a significant improvement in cardiac function. The results showed that SGLT2i combined with conventional therapy has a better beneficial effect on left ventricular volumes and cardiac function in NIDCM patients.
