Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study.
AIMS Dapagliflozin improves the prognosis of patients with heart failure (HF), regardless of left ventricular ejection fraction (LVEF). However, its effect on cardiac remodelling parameters, specifically left atrial (LA) remodelling, is not well established. METHODS AND RESULTS The DAPA-MODA trial (...
| Autores: | , , , , , , , , , , , , , , , |
|---|---|
| Tipo de documento: | artigo |
| Data de publicação: | 2023 |
| País: | España |
| Recursos: | Instituto de Salud Carlos III (ISCIII) |
| Repositório: | Repisalud |
| Idioma: | inglês |
| OAI Identifier: | oai:repisalud.isciii.es:20.500.12105/16414 |
| Acesso em linha: | http://hdl.handle.net/20.500.12105/16414 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Heart Failure Humans Ventricular Function, Left Stroke Volume Prospective Studies Ventricular Remodeling |
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Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study.Pascual-Figal, Domingo AZamorano, J LuisDomingo, MarMorillas, HerminioNuñez, JulioCobo Marcos, MartaRiquelme-Pérez, AlejandroTeis, AlbertSantas, EnriqueCaro-Martinez, CesarPinilla, Jose ManuelRodriguez-Palomares, Jose FDobarro, DavidRestrepo-Córdoba, M AlejandraGonzález-Juanatey, J RamónBayés Genís, AntoniHeart FailureHumansVentricular Function, LeftStroke VolumeProspective StudiesVentricular RemodelingAIMS Dapagliflozin improves the prognosis of patients with heart failure (HF), regardless of left ventricular ejection fraction (LVEF). However, its effect on cardiac remodelling parameters, specifically left atrial (LA) remodelling, is not well established. METHODS AND RESULTS The DAPA-MODA trial (NCT04707352) is a multicentre, single-arm, open-label, prospective and interventional study that aimed to evaluate the effect of dapagliflozin on cardiac remodelling parameters over 6 months. Patients with stable chronic HF receiving optimized guideline-directed therapy, except for any sodium-glucose cotransporter 2 inhibitor, were included. Echocardiography was performed at baseline, 30 and 180 days, and analysed by a central core-lab in a blinded manner to both patient and time. The primary endpoint was the change in maximal LA volume index (LAVI). A total of 162 patients (64.2% men, 70.5 ± 10.6 years, 52% LVEF >40%) were included in the study. At baseline, LA dilatation was observed (LAVI 48.1 ± 22.6 ml/m2 ) and LA parameters were similar between LVEF-based phenotypes (≤40% vs. >40%). LAVI showed a significant reduction at 180 days (-6.6% [95% confidence interval -11.1, -1.8], p = 0.008), primarily due to a decrease in reservoir volume (-13.8% [95% confidence interval -22.5, -4], p = 0.007). Left ventricular geometry improved with significant reductions in left ventricular mass index (-13.9% [95% confidence interval -18.7, -8.7], p < 0.001), end-diastolic volume (-8.0% [95% confidence interval -11.6, -4.2], p < 0.001) and end-systolic volume (-11.9% [95% confidence interval -16.7, -6.8], p < 0.001) at 180 days. N-terminal pro-B-type natriuretic peptide (NT-proBNP) showed a significant reduction at 180 days (-18.2% [95% confidence interval -27.1, -8.2], p < 0.001), without changes in filling Doppler measures. CONCLUSION Dapagliflozin administration in stable out-setting patients with chronic HF and optimized therapy results in global reverse remodelling of cardiac structure, including reductions in LA volumes and improvement in left ventricular geometry and NT-proBNP concentrations.WileySociedad Española de CardiologíaAstraZeneca20232023-09-0520232023-08-0120232023-08-01journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/16414reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/164142026-06-12T12:43:37Z |
| dc.title.none.fl_str_mv |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| title |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| spellingShingle |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. Pascual-Figal, Domingo A Heart Failure Humans Ventricular Function, Left Stroke Volume Prospective Studies Ventricular Remodeling |
| title_short |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| title_full |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| title_fullStr |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| title_full_unstemmed |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| title_sort |
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study. |
| dc.creator.none.fl_str_mv |
Pascual-Figal, Domingo A Zamorano, J Luis Domingo, Mar Morillas, Herminio Nuñez, Julio Cobo Marcos, Marta Riquelme-Pérez, Alejandro Teis, Albert Santas, Enrique Caro-Martinez, Cesar Pinilla, Jose Manuel Rodriguez-Palomares, Jose F Dobarro, David Restrepo-Córdoba, M Alejandra González-Juanatey, J Ramón Bayés Genís, Antoni |
| author |
Pascual-Figal, Domingo A |
| author_facet |
Pascual-Figal, Domingo A Zamorano, J Luis Domingo, Mar Morillas, Herminio Nuñez, Julio Cobo Marcos, Marta Riquelme-Pérez, Alejandro Teis, Albert Santas, Enrique Caro-Martinez, Cesar Pinilla, Jose Manuel Rodriguez-Palomares, Jose F Dobarro, David Restrepo-Córdoba, M Alejandra González-Juanatey, J Ramón Bayés Genís, Antoni |
| author_role |
author |
| author2 |
Zamorano, J Luis Domingo, Mar Morillas, Herminio Nuñez, Julio Cobo Marcos, Marta Riquelme-Pérez, Alejandro Teis, Albert Santas, Enrique Caro-Martinez, Cesar Pinilla, Jose Manuel Rodriguez-Palomares, Jose F Dobarro, David Restrepo-Córdoba, M Alejandra González-Juanatey, J Ramón Bayés Genís, Antoni |
| author2_role |
author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Sociedad Española de Cardiología AstraZeneca |
| dc.subject.none.fl_str_mv |
Heart Failure Humans Ventricular Function, Left Stroke Volume Prospective Studies Ventricular Remodeling |
| topic |
Heart Failure Humans Ventricular Function, Left Stroke Volume Prospective Studies Ventricular Remodeling |
| description |
AIMS Dapagliflozin improves the prognosis of patients with heart failure (HF), regardless of left ventricular ejection fraction (LVEF). However, its effect on cardiac remodelling parameters, specifically left atrial (LA) remodelling, is not well established. METHODS AND RESULTS The DAPA-MODA trial (NCT04707352) is a multicentre, single-arm, open-label, prospective and interventional study that aimed to evaluate the effect of dapagliflozin on cardiac remodelling parameters over 6 months. Patients with stable chronic HF receiving optimized guideline-directed therapy, except for any sodium-glucose cotransporter 2 inhibitor, were included. Echocardiography was performed at baseline, 30 and 180 days, and analysed by a central core-lab in a blinded manner to both patient and time. The primary endpoint was the change in maximal LA volume index (LAVI). A total of 162 patients (64.2% men, 70.5 ± 10.6 years, 52% LVEF >40%) were included in the study. At baseline, LA dilatation was observed (LAVI 48.1 ± 22.6 ml/m2 ) and LA parameters were similar between LVEF-based phenotypes (≤40% vs. >40%). LAVI showed a significant reduction at 180 days (-6.6% [95% confidence interval -11.1, -1.8], p = 0.008), primarily due to a decrease in reservoir volume (-13.8% [95% confidence interval -22.5, -4], p = 0.007). Left ventricular geometry improved with significant reductions in left ventricular mass index (-13.9% [95% confidence interval -18.7, -8.7], p < 0.001), end-diastolic volume (-8.0% [95% confidence interval -11.6, -4.2], p < 0.001) and end-systolic volume (-11.9% [95% confidence interval -16.7, -6.8], p < 0.001) at 180 days. N-terminal pro-B-type natriuretic peptide (NT-proBNP) showed a significant reduction at 180 days (-18.2% [95% confidence interval -27.1, -8.2], p < 0.001), without changes in filling Doppler measures. CONCLUSION Dapagliflozin administration in stable out-setting patients with chronic HF and optimized therapy results in global reverse remodelling of cardiac structure, including reductions in LA volumes and improvement in left ventricular geometry and NT-proBNP concentrations. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023 2023-09-05 2023 2023-08-01 2023 2023-08-01 |
| dc.type.none.fl_str_mv |
journal article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
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info:eu-repo/semantics/article |
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article |
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http://hdl.handle.net/20.500.12105/16414 |
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http://hdl.handle.net/20.500.12105/16414 |
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Inglés eng |
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Inglés |
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eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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application/pdf |
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Wiley |
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Wiley |
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reponame:Repisalud instname:Instituto de Salud Carlos III (ISCIII) |
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Instituto de Salud Carlos III (ISCIII) |
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