Reis João, Teixeira Ana Rita, Gonçalves António Valentim, Moreira Rita Ilhão, Silva Tiago Pereira, Timóteo Ana Teresa, Ferreira Rui Cruz
Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar e Universitário de Lisboa Central, Rua de Santa Marta 50, 1169-024 Lisbon, Portugal.
J Clin Med. 2022 May 23;11(10):2935. doi: 10.3390/jcm11102935.
Background: Dapagliflozin has been shown to reduce morbidity and mortality in Heart Failure with reduced Ejection Fraction (HFrEF), but its impact on exercise capacity of non-diabetic HF outpatients is unknown. Methods: Adult non-diabetic HF patients with a left ventricular ejection fraction (LVEF) <50% were randomized 1:1 to receive dapagliflozin 10 mg or to continue with HF medication. Patients underwent an initial evaluation which was repeated after 6 months. The variation of several clinical parameters was compared, with the primary endpoint being the 6 month peak oxygen uptake (pVO2) variation. Results: A total of 40 patients were included (mean age 61 ± 13 years, 82.5% male, mean LVEF 34 ± 5%), half being randomized to dapagliflozin, with no significant baseline differences between groups. The reported drug compliance was 100%, with no major safety events. No statistically significant difference in HF events was found (p = 0.609). There was a 24% reduction in the number of patients in New York Heart Association (NYHA) class III in the treatment group as opposed to a 15.8% increase in the control group (p = 0.004). Patients under dapagliflozin had a greater improvement in pVO2 (3.1 vs. 0.1 mL/kg/min, p = 0.030) and a greater reduction in NT-proBNP levels (−217.6 vs. 650.3 pg/mL, p = 0.007). Conclusion: Dapagliflozin was associated with a significant improvement in cardiopulmonary fitness at 6 months follow-up in non-diabetic HFrEF patients.
达格列净已被证明可降低射血分数降低的心力衰竭（HFrEF）患者的发病率和死亡率，但其对非糖尿病心力衰竭门诊患者运动能力的影响尚不清楚。方法：左心室射血分数（LVEF）<50%的成年非糖尿病心力衰竭患者按1:1随机分组，分别接受10 mg达格列净治疗或继续使用心力衰竭药物。患者接受了初始评估，并在6个月后重复进行。比较了几个临床参数的变化，主要终点是6个月时的峰值摄氧量（pVO2）变化。结果：共纳入40例患者（平均年龄61±13岁，男性占82.5%，平均LVEF 34±5%），一半患者随机接受达格列净治疗，两组间基线无显著差异。报告的药物依从性为100%，无重大安全事件。未发现心力衰竭事件有统计学显著差异（p = 0.609）。治疗组纽约心脏协会（NYHA）III级患者数量减少24%，而对照组增加15.8%（p = 0.004）。接受达格列净治疗的患者pVO2改善更大（3.1 vs. 0.1 mL/kg/min，p = 0.030），NT-proBNP水平降低更大（−217.6 vs. 650.3 pg/mL，p = 0.007）。结论：在非糖尿病HFrEF患者6个月的随访中，达格列净与心肺功能的显著改善相关。
