Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial
Jagdeep S S Singh, Ify R Mordi, Keeran Vickneson, Amir Fathi, Peter T Donnan, Mohapradeep Mohan, Anna Maria J Choy, Stephen Gandy, Jacob George, Faisel Khan, Ewan R Pearson, J Graeme Houston, Allan D Struthers, Chim C Lang, Jagdeep S S Singh, Ify R Mordi, Keeran Vickneson, Amir Fathi, Peter T Donnan, Mohapradeep Mohan, Anna Maria J Choy, Stephen Gandy, Jacob George, Faisel Khan, Ewan R Pearson, J Graeme Houston, Allan D Struthers, Chim C Lang
Abstract
Objective: To determine the effects of dapagliflozin in patients with heart failure (HF) and type 2 diabetes mellitus (T2DM) on left ventricular (LV) remodeling using cardiac MRI.
Research design and methods: We randomized 56 patients with T2DM and HF with LV systolic dysfunction to dapagliflozin 10 mg daily or placebo for 1 year, on top of usual therapy. The primary end point was difference in LV end-systolic volume (LVESV) using cardiac MRI. Key secondary end points included other measures of LV remodeling and clinical and biochemical parameters.
Results: In our cohort, dapagliflozin had no effect on LVESV or any other parameter of LV remodeling. However, it reduced diastolic blood pressure and loop diuretic requirements while increasing hemoglobin, hematocrit, and ketone bodies. There was a trend toward lower weight.
Conclusions: We were unable to determine with certainty whether dapagliflozin in patients with T2DM and HF had any effect on LV remodeling. Whether the benefits of dapagliflozin in HF are due to remodeling or other mechanisms remains unknown.
Trial registration: ClinicalTrials.gov NCT02397421.
© 2020 by the American Diabetes Association.
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Source: PubMed