Ventricular remodeling with dapagliflozin in elderly women with HFpEF--a single center prospective study

Purpose To investigate the clinical efficacy and prognosis of dapagliflozin in elderly women with heart failure with preserved ejection fraction (HFpEF). Methods From March 2022 to September 2023, 299 elderly female patients with HFpEF were randomly divided into control group (n = 149) and dapagliflozin group (n = 150) by random number method. Baseline clinical data and laboratory test results were collected. The changes of relevant results before and after treatment in each group were sorted out and compared. After discharge, the enrolled patients were followed up by outpatient or telephone for an average of 12 months, and were followed up for rehospitalization of heart failure, occurrence of ventricular arrhythmia and major adverse cardiovascular events (MACE). Results After anti-heart failure therapy, N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected between the two groups. Soluble growth stimulation expressed gene 2 (ST2), Galectin-3 (Gal-3) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were statistically significant. NT-proBNP, Gal-3 and MLHFQ in dapagliflozin group were significantly lower than those in control group after treatment (all P < 0.05). After 12 months of treatment in the dapagliflozin group, left ventricular ejection fraction (LVEF), Estimated glomerular filtration rate (eGFR)and Direct Bilirubin (DBil)((all P < 0.05)were significantly higher than those before treatment. After 12 months, c-reactiveprotein (CRP) was significantly lower than that before treatment in the dapagliflozin group. Na levels in dapagliflozin group was significantly increaser. MACE events in dapagliflozin group were significantly decreased (P < 0.05). Conclusion The clinical efficacy and prognosis of elderly female HFpEF patients were significantly improved after treatment with dapagliflozin.