Effects of Dapagliflozinon Right Ventricular Function Assessed by Different Echocardiographic Parameters in Patients with Heart Failure with Preserved Ejection Fraction

Abstract Background: Sodium-glucose co-transporter 2 (SGLT2) inhibitions reduce cardiovascular eventsin patients with type 2 diabetes (T2DM) and are associated with a reduction in left ventricular (LV) mass index. However, the impact on right ven-tricular (RV) remodeling is unknown. Dapagliflozin was proven to decrease cardiovascular death, heart failure hospitalization in patients who have an ejection fraction of 40% or less. However the impact on patients who have preserved ejection fraction is not yet proven, there have been many advances in noninvasive RV imaging during the past decade, echocardiography remains the most accessible and easiest method to assess RV volumes and functions. Aim of Study: This study aimed to examine the effect of dapagliflozin on RV function assessed by different methods in patients with heart failure with preserved ejection fraction (HF-pEF) and T2DM at baseline and after 6 months of treatment. Patients and Methods: This study was carried-out on 40 patients with definite diagnosis of HFpEF. The patients were collected from Al-Arish University Hospital (Cairo, Egypt). All patients included in the study were subjected to different echocardiography parameters, both conventional parameters right ventricle / left ventricle diameter ratio, RV fractional area change, tricuspid annular plane systolic excursion (TAPSE), tricuspid valve (TV) TDI velocity, and RV speckle tracking parameters(RV global strain (RV GS) and RV free wall strain before treatment and after 6 months of medical treatment that include dapagliflozin. Results: All echocardiographic parameters mean ± SD as-sessed in blinded fashion at baseline as follow TAPSE (17.02), FAC (33.85%), RV diameter/LV diameter ratio >1 (52.5%), RVOT Systolic excursion (4.55mm), RV GS (-17.17). RV free wall strain (-21.17), PAP (32mmHg) and after using the dapagliflozin were TAPSE (20.97), FAC (36.9%) RV diameter/LV diameter ratio >1 (not recorded), RVOT Systolic excursion (5.52mm), RVGS (-20.7), RV free wall strain (-24.72), PAP (20mmHg). There was significant correlation between effects of using dapagliflozin on RV improvement changes from base-line to 6 months. Conduction of this Study: This study concluded that treat-ment with dapagliflozin for diabetic patients type 2 with HFpEF enhanced the RV systolic function measured by different echo-cardiography parameters.