In December 2024, the Journal of the American College of Cardiology published
the results of a randomized, prospective, single-center, open-label DAPA ECHO Trial. The purpose of the study was to evaluate the effects of dapagliflozin on cardiac function (according to speckle-tracking echocardiography), as well as on clinical outcomes in patients with heart failure (HF) (EF < 50%) without concomitant diabetes mellitus (DM).
The study included 88 outpatients (mean age 68 ± 13 years, 83% men) with HFrEF (n = 55) or HFmrEF (n = 33) without concomitant DM, who were on optimal medical therapy (OMT) (at least 6 months) with the exception of sodium-glucose cotransporter type 2 inhibitors.
Patients were randomly assigned to two groups: in the first group (n=44), dapagliflozin was added to the therapy at a dose of 10 mg per day, and the second group (n=44) continued the therapy. The observation period was 6 months.
At baseline, the groups did not differ in most clinical, demographic and echocardiographic parameters. After 6 months of observation, statistically significant positive dynamics of all speckle tracking echocardiography parameters (global longitudinal deformation of the LV, parameters of deformation of the left atrium and right ventricle) were revealed in the dapagliflozin group, while in the OMT group the changes were minor and statistically insignificant.
During the observation period, only one hospitalization for HF was recorded. There were no cases of death from cardiovascular diseases, as well as episodes of ventricular arrhythmias. Thus, the results of this study indicate an early positive effect of dapagliflozin on myocardial remodeling parameters in patients with heart failure without concomitant diabetes, as measured by spectrum-tracking echocardiography, and these changes are recorded earlier than the dynamics of the main echocardiographic parameters.
Pastore, M, Stefanini, A, Mandoli, G. et al. Dapagliflozin Effects on Cardiac Deformation in Heart Failure and Secondary Clinical Outcome. J Am Coll Cardiol Img. 2024 Dec, 17 (12) 1399–1408.
https://www.jacc.org/doi/10.1016/j.jcmg.2024.05.014
