Heart failure & cardiomyopathiesSecondary analysis
Dapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial
- Secondary analysis of the CAMEO-DAPA randomised trial
Authors' conclusion
In patients with HFpEF, treatment with Dapagliflozin improved systemic arterial compliance and venous capacitance during exercise, while reducing aortic characteristic impedance, suggesting a reduction in arterial wall stiffness.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) undergoing invasive hemodynamic exercise testing with simultaneous echocardiography
- Participants
- 37 patients
- Comparison
- Dapagliflozin vs placebo
- Primary endpoint
- Systemic arterial compliance and venous capacitance during exercise
- Follow-up
- 24 weeks
Primary result
As reported in the abstract
Exercise haemodynamics: arterial compliance and venous capacitance
Dapagliflozin vs PlaceboEstimated treatment difference, mm Hg (95% CI)P value
SBP at peak exercise
−18.8(−33.9 to −3.7)
P = 0.016estimated stressed blood volume, rest and peak exercise
−292(−530 to −53)
P = 0.018Dapagliflozin vs PlaceboEstimated treatment difference (95% CI)P value
ratio of estimated stressed blood volume to total blood volume (venous capacitance)
−7.3%(−13.3 to −1.3)
P = 0.020- Exertional total arterial compliance improved: ETD 0.06 mL/mm Hg/m² (95% CI 0.003-0.11)
- P = 0.039
- Aortic root characteristic impedance reduced: ETD −2.6 mm Hg/mL*sec (95% CI −5.1 to −0.03)
- P = 0.048
Further findings
Correlations
- Reduction in SBP vs change in estimated stressed blood volume during exercise
- r=0.40, P=0.019
- Decreases in BP vs reduction in pulmonary capillary wedge pressure during exercise
- r=0.56, P<0.001
Original publication
Dapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial. Circulation. Published 5 August 2024. doi:10.1161/circulationaha.124.068788
Summarised from the published abstract; every number is checked against it