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Impact of dapagliflozin on key pathophysiological pathways underlying chronic heart failure progression: the

Verónica Martínez-Pina1, Antoni Bayés Genís2, Julio Nuñez3

  • 1Servicio de Bioquímica Clínica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.

Revista Espanola De Cardiologia (English Ed.)
|November 29, 2025
PubMed

Insights

Dapagliflozin treatment significantly reduced key heart failure biomarkers like NT-proBNP and MR-proADM. The drug favorably modulated various pathophysiological pathways, especially in patients with elevated baseline levels.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biomarker Research

Background:

  • Dapagliflozin improves chronic heart failure (HF) outcomes regardless of ejection fraction.
  • Its impact on biomarkers reflecting specific HF pathophysiological pathways needs further elucidation.

Purpose of the Study:

  • To investigate the effects of dapagliflozin on circulating biomarkers across five key pathophysiological pathways in chronic HF patients.
  • To understand the differential modulation of these biomarkers by dapagliflozin.

Main Methods:

  • Prospective, single-arm DAPA-MODA biomarker substudy (n=156) in stable chronic HF patients.
  • Measurement of 11 biomarkers (cardiac stress, inflammation, neurohormonal activation, congestion, fibrosis) at baseline, 1 month, and 6 months.
  • Patients received optimized therapy excluding SGLT2 inhibitors prior to the study.

Main Results:

  • Elevated baseline markers for myocardial stress (NT-proBNP, MR-proANP), injury (troponin), inflammation (IL-6, CRP, GDF-15), and neuro-endocrine stress (copeptin).
  • Dapagliflozin significantly reduced NT-proBNP and MR-proADM by 6 months.
  • Modest reductions observed for MR-proANP, CRP, IL-6, copeptin, and PINP in patients with elevated baseline levels; ST2 and CA-125 unchanged; GDF-15 increased.

Conclusions:

  • Dapagliflozin favorably impacts multiple pathophysiological pathways in chronic HF.
  • The drug's effects on biomarkers are differential, particularly influencing those elevated at baseline.
Abstract

Keywords:
BiomarcadoresBiomarkersDapagliflozinDapagliflozinaHeart failureInsuficiencia cardiaca

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