Effects Of Dapagliflozin On Preserved Ejection Fraction Heart Failure With Type 2 Diabetes

Background and aimsHeart failure with preserved ejection fraction(HFp EF)is a type of heart failure mainly characterized by impaired diastolic function,Compared with Heart failure with reduced ejection fraction(HFr EF),it has higher morbidity,higher heterogeneity,and similar case fatality rate and long-term prognosis.However,the current understanding of HFp EF is still relatively vague,and there is no specific treatment to improve the patient’s prognosis.Sodium-glucose contransporter 2 inhibitor(SGLT2i)is a new class of oral hypoglycemic drugs with the function beyond hypoglycemic。Dapagliflozin,a representative of these,was previously shown to reduce the risk of cardiovascular death and heart failure rehospitalization in patients with HFr EF in the CVOT cardiovascular outcome test.However,no clinical studies have confirmed whether Dapagliflozin can produce similar therapeutic effects in HFp EF complicated with type 2 diabetes mellitus(T2DM).Therefore,this study will explore the role of Dapagliflozin in this group of people,trying to prove the hypoglycemic efficacy of Dapagliflozin in HFp EF complicated with T2 DM,to reduce the level of markers of heart failure,and to improve the indicators of diastolic function of patients.MethodsThis research was a prospective randomized single-blind controlled study.Totally48 patients with HFp EF complicated with T2 DM in the First Affiliated Hospital of Nanchang University from June 2019 to June 2020 were selected.They were randomly divided into observation group(24cases)and the control group(24cases).The two groups were treated by conventional hypoglycemic regimen and conventional anti-heart failure therapy.The observation group was given additional Dapagliflozin(10mg/d)treatment.After 6 months of treatment,the indicators of heart failure、blood glucose、echocardiography and adverse drug reaction.Results1.There were no significant different of basic characterristics between two groups(P>0.05).2.After 6 months,2 people who had lost contact in the observation group were excluded,and a total of 46 patients were included for statistical analysis:the drug group of patient had an significant decreased serum NT-pro BNP and systolic pressure(P < 0.05);The average E/e’ were significantly improved in the drug group[(10.0±1.3)VS(11.0±1.6)P<0.05] 。Whereas,the LVEDD、LAD had no significant differences between two groups(P>0.05).3.After six months of treatment,there was no significant difference in ADR between the two groups.(P>0.05)ConclusionsIn the short term,Dapagliflozin can decrease serum NT-pro BNP 、 systolic pressure and improve the mean E/ e ’value of fluid dynamics indexes,And the drug is relatively safe,no obvious adverse reactions,but,the therapy has no benificial effect on LVEDD and LAD in short-term.