Effect of Dapagliflozin on Left Ventricular Diastolic Function in Diabetics - A Prospective Interventional Study

Abstract

Objectives: In patients with established heart failure, the SGLT2 inhibitor dapagliflozin found to alleviate the risk of worsening heart failure or cardiovascular mortality regardless of the presence of Diabetes Mellitus. To evaluate the effect of Dapagliflozin on Left Ventricular Diastolic function in Patients with Type 2 Diabetes Mellitus, to study the baseline Diastolic function in patients with type 2 diabetes mellitus and to study the Diastolic function at rest and after exercise in patients with type 2 diabetes mellitus 24 weeks after taking Dapagliflozin. Materials and Methods: It is a Prospective interventional Pilot study with study population consisting of T2DM who are 18 years and older with HbA1C between 7.0% to 10% and LV diastolic dysfunction of at least grade 1 on resting echocardiography. Baseline diastolic function was measured. Dapagliflozin 10 mg once daily was given to all patients for 24 weeks and then left ventricular diastolic function was measured by e’, E/A ratio, E/e’ at 24 weeks from baseline as assessed by Stress Echocardiography. Results: Diastolic Dysfunction grading between Baseline and post 24 weeks treatment with dapagliflozin, using Marginal Homogeneity Test showed p value <0.001 which is highly significant. Comparision of e’ at rest for baseline and post 24 weeks of treatment with dapagliflozin showed statistical significance. The e’ after exercise for baseline and post 24 weeks of treatment showed p value of <0.01. Comparision of E/e’ at rest and after exercise for baseline and post 24 weeks showed statistical significance. Conclusion: The diastolic function has been significantly improved after 24 weeks of using dapagliflozin. The diastolic function parameters between age and sex groups at baseline and post 24 weeks of treatment with dapagliflozin does not correlate.