Heart failure & cardiomyopathiesCohort study
Dapagliflozin effects on right ventricular function, pulmonary pressure and coupling: a propensity score analysis from the RIVED-HF
- prospective observational registry with propensity score analysis
Authors' conclusion
In a real-world HF cohort, dapagliflozin was associated with improved RV morphology and function, lower PASP, and better RV-PA coupling, suggesting a direct haemodynamic and RV-targeted benefit beyond LV remodelling.
Study context
- Population
- Patients with chronic heart failure (CHF)final population analysed, balanced dataset
- Participants
- 142 patients
- Exposure
- dapagliflozin compared with standard therapy in CHF
- Dapa groupn = 71
- control groupn = 71
Main finding
As reported in the abstract
Right ventricular (RV) function (TAPSE, S') · 6 months
- Dapa group vs control group
- Tricuspid annular peak systolic excursion (TAPSE) change +1.03 mm; P < 0.001
- Dapa group vs control group
- S' change +0.48 cm/s; P = 0.006
Observational data: associations, not effects.
Secondary outcomes
PASP in patients with PH · significant decrease in PASP · patients with PH
P < 0.001
| Outcome | Dapa group | control group | Estimate | P value |
|---|---|---|---|---|
| RV GLS at follow-up · 6 months · significantly improved in the Dapagliflozin group | adjusted mean difference −1.54% | P < 0.001 | ||
| TAPSE/PASP (pulmonary-arterial coupling) · 6 months | adjusted differences ranging from +0.07 to +0.17 | P = 0.025 | ||
| RVGLS in patients with PH · significant improvement in the Dapagliflozin group · patients with PH | −20 (range as printed −22–-19) | −19 (range as printed −20–-17) | P < 0.001 | |
| TAPSE/PASP ratio · significantly improved in Dapagliflozin group | 0.67 (range as printed 052–0.78) | 0.51 (range as printed 0.42–0.61) | P < 0.001 | |
| Baseline characteristics · younger in Dapa group | age, years 76 (66-82) vs 82 (74-88) | P < 0.001 | ||
| Baseline characteristics | diabetes mellitus 44% vs 22% | P = 0.002 | ||
| NT-proBNP levels change (secondary endpoint) · baseline to follow-up · significantly improved only in dapaglifozin group | from 938 to 726 pg/mL | Not reported in the abstract |
- Baseline characteristics — Median age
- 78 [75-84] years
- Baseline characteristics — men
- 62%
- NT-proBNP levels change (secondary endpoint): P = .013
Fractional area changes (FAC) · 6 months
- no significant differences between-groups
- P = 0.16
Safety
Combined adverse events (mortality and hospitalization) (secondary endpoint) · 180 days · significantly higher in control group
P < 0.01
Original publication
Dapagliflozin effects on right ventricular function, pulmonary pressure and coupling: a propensity score analysis from the RIVED-HF. ESC Heart Fail. Published 1 September 2026. doi:10.1093/eschf/xvag230
Summarised from the published abstract; every number is checked against it