Heart failure & cardiomyopathies
Targeted Metabolomic Profiling of Dapagliflozin in Heart Failure With Preserved Ejection Fraction: The PRESERVED-HF Trial
Authors' conclusion
Leveraging targeted metabolomics in a placebo-controlled SGLT2i trial of HFpEF, dapagliflozin did not alter systemic metabolic as reflected by circulating metabolites, in contrast with reported effects in HF with reduced ejection fraction.
Study context
- Population
- Patients with HF with preserved ejection fraction (HFpEF) in a 12-week trial; mean age 70 ± 11 years, 58% female, 29% Black
- Participants
- 293 patients
- Comparison
- Dapagliflozin vs placebo
- Primary endpoint
- Changes in 64 targeted metabolites (12 PCA-derived metabolite factors)
- Follow-up
- 12 weeks
Methodological detailsplacebo-controlled, targeted metabolomic profiling
- Placebo-controlled
- Targeted metabolomic profiling
Primary result
As reported in the abstract
12 PCA-derived metabolite factors
- No significant differences in 12 principal components analysis (PCA)-derived metabolite factors between arms, incl. ketone, fatty acid or branched-chain amino acid (BCAA) pathways
Further findings
Metabolite changes vs changes in study endpoints (arms combined)
- Changes in BCAAs and branched-chain ketoacids negatively associated with changes in NT-proBNP
- Changes in medium-/long-chain acylcarnitines positively associated with NT-proBNP changes and negatively with 6-minute walk distance changes
- Changes in ketones negatively associated with weight changes
- Without treatment interaction
Original publication
Targeted Metabolomic Profiling of Dapagliflozin in Heart Failure With Preserved Ejection Fraction: The PRESERVED-HF Trial. JACC Heart Fail. Published 17 April 2024. doi:10.
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