Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial

TY - JOUR

T1 - Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial

AU - Singh, J. S. S.

AU - Mordi, I. R.

AU - Vickneson, K.

AU - Fathi, A.

AU - Donnan, P. T.

AU - Mohan, M.

AU - Choy, A. M. J.

AU - Gandy, S.

AU - George, J.

AU - Khan, F.

AU - Pearson, E. R.

AU - Houston, J. G.

AU - Struthers, A. D.

AU - Lang, C. C.

N1 - Singh, Jagdeep S S Mordi, Ify R Vickneson, Keeran Fathi, Amir Donnan, Peter T Mohan, Mohapradeep Choy, Anna Maria J Gandy, Stephen George, Jacob Khan, Faisel Pearson, Ewan R Houston, J Graeme Struthers, Allan D Lang, Chim C 2020/4/5

PY - 2020

Y1 - 2020

N2 - 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.|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.|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.|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.

AB - 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.|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.|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.|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.

KW - Aged Benzhydryl Compounds Cohort Studies Diabetes Mellitus, Type 2 Diabetic Angiopathies Female Glucosides Heart Failure Heart Ventricles Humans Male Middle Aged Placebos Stroke Volume Ventricular Dysfunction, Left Ventricular Remodeling

U2 - 10.2337/dc19-2187

DO - 10.2337/dc19-2187

M3 - Article

SN - 1935-5548

VL - 43

SP - 1356

EP - 1359

JO - Diabetes Care

JF - Diabetes Care

IS - 6

ER -