Evidence map›Paper›PMID 39578847›Full record

Observational studyCardiovascular diabetology2024

The effects of Dapagliflozin in a real-world population of HFrEF patients with different hemodynamic profiles: worse is better.

Francesco Loria, Pasquale Mone, Antonella Rispoli, Rosanna Di Fonzo, Daniele Masarone, Costantino Mancusi, Michele Correale, Antonio Vitullo, Michele Granatiero, Pietro Mazzeo and 15 more

Abstract readObservational StudyMulticenter StudyComparative Study
In one paragraph

Observational study in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Francesco LoriaDepartment of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via Salvador Allende, 84081, Baronissi, Salerno, Italy.
Pasquale MoneDepartment of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
Antonella RispoliDepartment of Cardiology, "San Giovanni di Dio e Ruggi D'Aragona" Hopital-University, Salerno, Italy.
Rosanna Di FonzoDepartment of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via Salvador Allende, 84081, Baronissi, Salerno, Italy.
Daniele MasaroneHeart Failure Unit, AORN Colli, Naples, Italy.
Costantino MancusiDepartment of Advanced Biomedical Sciences, Federico II University of Naples, 80138, Naples, Italy.
Michele CorrealeCardiology Department, Ospedali Riuniti University Hospital, Foggia, Italy.
Antonio VitulloCardiology Department, Ospedali Riuniti University Hospital, Foggia, Italy.
Michele GranatieroCardiology Department, Ospedali Riuniti University Hospital, Foggia, Italy.
Pietro MazzeoDivision of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", Potenza, Italy.
Valentina MercurioDepartment of Translational Medical Sciences, Federico II University, Naples, Italy.
Francesco FioreDepartment of Translational Medical Sciences, Federico II University, Naples, Italy.
Elena Di SarroDepartment of Translational Medical Sciences, Federico II University, Naples, Italy.
Luigi FalcoHeart Failure Unit, AORN Colli, Naples, Italy.
Carmine IzzoDepartment of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via Salvador Allende, 84081, Baronissi, Salerno, Italy.
Alfonso CampanileDepartment of Cardiology, "San Giovanni di Dio e Ruggi D'Aragona" Hopital-University, Salerno, Italy.
Nicola VirtuosoDepartment of Cardiology, "San Giovanni di Dio e Ruggi D'Aragona" Hopital-University, Salerno, Italy.
Eugenio StabileDivision of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", Potenza, Italy.
Salvatore BonannoDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy.
Giuseppe DattiloDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy.
Carlo Gabriele TocchettiDepartment of Translational Medical Sciences, Federico II University, Naples, Italy.
Gaetano SantulliDepartment of Medicine, Einstein Institute for Aging Research, Einstein Institute for Neuroimmunology and Neuroinflammation, Albert Einstein College of Medicine, New York, USA.
Carmine VecchioneDepartment of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via Salvador Allende, 84081, Baronissi, Salerno, Italy.
Michele CiccarelliDepartment of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via Salvador Allende, 84081, Baronissi, Salerno, Italy. mciccarelli@unisa.it.
Valeria ViscoDepartment of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Via Salvador Allende, 84081, Baronissi, Salerno, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSodium-Glucose Cotransporter-2 inhibitors (SGLT2i) represent a deep revolution of the therapeutic approach to heart failure (HF), preventing its insurgence but also improving the management of the disease and slowing its natural progression. To date, few studies have explored the effectiveness of SGLT2i and, in particular, Dapagliflozin in a real-world population. Therefore, in this observational prospective study, we evaluated Dapagliflozin's effectiveness in a real-world HF population categorized in the different hemodynamic profiles.

methodsFrom January 2022 to June 2023, we enrolled 240 patients with chronic HF and reduced ejection fraction (HFrEF) on optimal medical therapy, according to 2021 ESC guidelines, that added treatment with Dapagliflozin from the HF Clinics of 6 Italian University Hospitals. Clinical, biochemical, and echocardiographic parameters were collected before and after 6 months of Dapagliflozin introduction. Moreover, the HFrEF population was classified according to hemodynamic profiles (A: SV ≥ 35 ml/m

resultsDapagliflozin population (67.18 ± 11.11 years) showed a significant improvement in the echocardiographic and functional parameters (left ventricular ejection fraction [LVEF], LV end-diastolic volume [LVEDV], LVEDV index, stroke volume index [SVi], left atrium volume index [LAVi], filling pressure [E/e' ratio], tricuspid annular plane systolic excursion [TAPSE], tricuspid annular S' velocity [RVs'], fractional area change [FAC], inferior vena cava [IVC diameter], pulmonary artery systolic pressure [sPAP], NYHA class, and quality of life) compared to baseline. In particular, TAPSE and right ventricle diameter (RVD1) ameliorate in congestive profiles (B and D); accordingly, the furosemide dose significantly decreased in these profiles. Comparing the three populations, the analysis of echocardiographic parameters (baseline vs follow-up) highlighted a significant decrease of sPAP in the Dapagliflozin population (p < 0.05), while no changes were recorded in the GL 2012 and GL 2016 population. Moreover, at the baseline evaluation, the GL 2012 and 2016 groups needed a higher significant dose of furosemide compared to Dapagliflozin group. Finally, Dapagliflozin patients had significantly fewer rehospitalizations (1.25%) compared with the other two groups (GL 2012 18.89%, p 0.0097; GL 2016 15.32%, p 0.0497).

conclusionsWe demonstrate that Dapagliflozin is rapidly effective in an HFrEF real-world population; furthermore, the more significant effect is recorded in HFrEF patients with a congestive profile (B and D), supporting the introduction of Dapagliflozin in patients with a congestive profile and a worse prognosis. In conclusion, our data suggest evaluating the patient's hemodynamic state beyond LVEF in HFrEF.

Indexed as

Benzhydryl CompoundsGlucosidesHeart FailureSodium-Glucose Transporter 2 InhibitorsStroke VolumeVentricular Function, LeftAgedFemaleHemodynamicsHumansItalyMaleMiddle AgedProspective StudiesRecovery of FunctionTime FactorsBenzhydryl CompoundsdapagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsCardiac functionDapagliflozinHeart failure with reduced ejection fractionHemodynamic profileSGLT2 inhibitors

Identifiers

PMID39578847
PMCPMC11583416

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.