Impact de la Dapagliflozine sur les paramètres échocardiographiques chez les patients présentant une insuffisance cardiaque à fraction d’éjection réduite : « À propos d’une série monocentrique de 43 cas »

Abstract

IntroductionThe treatment of heart failure with reduced ejection fraction HFrEF (< 40%) uses hygienic-dietary rules combined with beta-blockers, renin-angiotensin system blockers RASB (alone or in combination with Sacubitril) and spironolactone. Dapagliflozin (SGLT2 inhibitor) has proven its effectiveness in reducing morbi-mortality in patients with HF. However, its effects on echocardiographic parameters are less known. ObjectiveTo describe the impact of the addition of Dapagliflozin to conventional treatment on echocardiographic parameters in patients with HFrEF < 40%. MethodObservational, single-center and non-randomized study involving patients with HFrEF < 40%. This group was compared to a cohort of 50 patients with HfrEF < 40% under conventional treatment without Dapagliflozin (taken from the HF register of our center and whose management dates back to before the adoption of this molecule in the HF ESC-2021 guidelines) to assess the ultrasound impact of Dapagliflozin. Results43 patients aged between 40 and 68 years with HfrEF < 40% on Beta-blocker, BSRA, Spironolactone and Dapagliflozin 10 mg/d. The mean EF was 33% ± 3 (30–39%), mean LVd diameter 64 mm ± 6 (55–71 mm) and mean longitudinal strain at -11% ± 4. These patients were compared to a cohort of 50 patients with the same profile without Dapagliflozin. After a follow-up of 7 months (5–8 months): The average EF increased to 37% with 11 patients EF > 40% against 35% and 5 patients EF > 40% for the group without Dapagliflozin (P 0.057), average LVd at 61 mm versus 66 mm in the group without Dapagliflozin (P 0.095), Mean longitudinal strain at −14% (6 patients < −15) versus −12% (1 patient <−15) in the group without Dapagliflozin (P 0.046). ConclusionIn a population of patients with HfrEF < 40% under conventional treatment for HF, the prescription of Dapagliflozin is associated with an improvement of echocardiographic parameters (EF and longitudinal strain). Mots-clésSérie;Dapagliflozine;insuffisance cardiaque;strain;ProBNP;dysfonction VG