Heart failure & cardiomyopathies
Dapagliflozin and Right Ventricular–Pulmonary Vascular Interaction in Heart Failure With Preserved Ejection Fraction: A Secondary Analysis of a Randomized Clinical Trial
Authors' conclusion
Results of this randomized clinical trial reveal that treatment with dapagliflozin for 24 weeks reduced pulsatile pulmonary vascular load and enhanced dynamic RV-PA interaction during exercise in patients with HFpEF, findings that are related to the magnitude of PCWP reduction.
Study context
- Population
- Patients with hemodynamically confirmed heart failure with preserved ejection fraction (HFpEF) with exercise pulmonary capillary wedge pressure (PCWP) ≥25 mm Hgrandomized
- Participants
- 37 patients
- Comparison
- Dapagliflozin vs placebo for 24 weeks
- Primary endpoint
- Pulsatile pulmonary vascular load (PA compliance and elastance) and RV performance (PA pulsatility index, RV s'/PA mean) during rest and exercise
- Follow-up
- 24 weeks
Methodological detailssingle-centre, Recruitment February 2021 to May 2022
- Single-centre
- Recruitment February 2021 to May 2022
Primary result
As reported in the abstract
Dapagliflozin vs PlaceboPlacebo-corrected mean difference, mL/mm Hg (95% CI)P value
PA compliance, exercise
0.57(0.11–1.03)
P = 0.02Dapagliflozin vs PlaceboDifference, mm Hg/mL (95% CI)P value
PA elastance (stiffness), exercise
−0.17(−0.28 to −0.07)
P = 0.001Further findings
Median change, seconds
| Outcome | Dapagliflozin | Placebo | P value |
|---|---|---|---|
| Resistance-compliance time (change) | 0.06 (IQR 0.03–0.15) | 0.01 (IQR −0.02–0.05) | P = 0.046 |
Correlation of improvements with reduction in right atrial (RA) pressure and PCWP
- RA pressure: Pulmonary artery (PA) elastance Pearson r
- 0.55; P =.008
- RA pressure: Right ventricular (RV) s'/PA elastance Pearson r
- −0.60; P =.002
- PCWP: PA elastance Pearson r
- 0.58; P <.001
- PCWP: RV s'/PA elastance Pearson r
- −0.47; P = .02
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Dapagliflozin and Right Ventricular–Pulmonary Vascular Interaction in Heart Failure With Preserved Ejection Fraction: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. Published 1 September 2024. doi:10.
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