Heart failure & cardiomyopathies
Dapagliflozin Effect On Functional Mitral Regurgitation and Myocardial Remodelling: The DEFORM Trial
Authors' conclusion
Dapagliflozin demonstrates the potential to further reduce the degree of MR and enhance myocardial remodelling in patients with FMR when used in addition to current GDMT. These findings suggest the importance of SGLT2i in heart failure patients with FMR as an additive positive effect on echocardiographic parameter and possibly outcome.
Study context
- Population
- Patients with moderate or severe functional mitral regurgitation (FMR) on current guideline-directed medical therapy (GDMT)
- Participants
- 104 patients
- Comparison
- Dapagliflozin vs. control
- Primary endpoint
- Change in effective regurgitant orifice area (EROA) of mitral regurgitation (MR)
- Follow-up
- 3 months
Methodological details1:1 ratio
- 1:1 ratio
Primary result
As reported in the abstract
Dapagliflozin
−0.074
change · ± 0.099 · cm²
Control
−0.030
change · ± 0.058 · cm²
P = 0.008
Secondary outcomes
| Outcome | Dapagliflozin | Control | Hazard ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| Hospitalization for heart failure · 3-month follow-up | 9.6% | 15.3% | 0.60 (0.20–1.83) | P = 0.368 | |
| Cardiovascular death · 3-month follow-up | 1.9% | 3.8% | 0.49 (0.04–5.41) | P = 0.561 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | Dapagliflozin | Control | P value |
|---|---|---|---|
| Change in regurgitant volume (RV) · 3 monthsSignificantly decreased with dapagliflozin | change −9.08 ± 15.27 mL | change −2.98 ± 9.28 mL | P = 0.017 |
| Change in E/e′ ratio · 3 monthsSignificantly decreased with dapagliflozin | change −5.88 ± 7.41 | change −1.98 ± 7.63 | P = 0.011 |
| Change in left atrial volume index (LAVI) · 3 monthsSignificantly decreased with dapagliflozin | change −2.50 ± 4.75 mL/m² | change −0.43 ± 3.14 mL/m² | P = 0.011 |
| Change in left ventricular ejection fraction (LVEF) · 3 monthsImproved with dapagliflozin | change 6.57 ± 10.10 % | change 1.92 ± 9.57 % | P = 0.017 |
Change in left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular mass (LVM) and left ventricular mass index (LVMI) · 3 months
- No significant differences between groups
- P > 0.05
Original publication
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