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Initial clinical experience with dapagliflozin in addition to optimized medical therapy in paediatric heart failure

Lisa-Maria Rosenthal1,2,3,4, Oliver Miera1,2, Annemarie Krauss1,2

  • 1Department of Congenital Heart Disease - Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.

ESC Heart Failure
|July 22, 2025
PubMed

Insights

Dapagliflozin is safe and well-tolerated in pediatric heart failure patients, showing improvements in heart function and symptoms. Further large-scale trials are needed to confirm these promising findings for pediatric heart failure management.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors, like dapagliflozin, are established treatments for adult heart failure (HF).
  • Limited data exist on the efficacy and safety of dapagliflozin in pediatric HF populations.

Purpose of the Study:

  • To evaluate the safety and clinical outcomes of dapagliflozin as an add-on therapy in pediatric HF patients.
  • To assess adverse events and changes in cardiac function markers in this population.

Main Methods:

  • A single-centre retrospective analysis of 37 pediatric HF patients treated with dapagliflozin.
  • Analysis of clinical outcomes, left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), NT-proBNP, and estimated glomerular filtration rate (eGFR) at baseline and follow-up.

Main Results:

  • Dapagliflozin was well-tolerated with no severe adverse effects.
  • Significant improvements were observed in LVEF (40% to 57%) and GLS (-9.2% to -14.7%).
  • Heart failure classification improved significantly, and NT-proBNP levels decreased.

Conclusions:

  • Dapagliflozin, combined with optimized HF therapy, is safe and well-tolerated in pediatric HF patients.
  • The treatment demonstrated improvements in functional class, left ventricular contractility, and HF symptoms.
  • Larger, prospective, multicentre trials are necessary to validate these findings due to the study's limitations (small sample size, retrospective design).
Abstract

Keywords:
DapagliflozinPaediatric heart failureSodium‐glucose cotransporter 2 inhibitor

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