Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial
Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial
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DOI：
10.2337/dc19-2187
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发表时间：
2020-06-01
期刊：
影响因子：
16.2
通讯作者：
Lang, Chim C.
中科院分区：
文献类型：
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作者：
Singh, Jagdeep S. S.;Mordi, Ify R.;Lang, Chim C.
目的通过心脏MRI观察达格列净对心力衰竭（HF）合并2型糖尿病（T2 DM）患者左室重构的影响。研究设计和方法：我们将56例伴有左室收缩功能障碍的T2 DM和HF患者随机分配至达格列净10 mg/d或安慰剂组，在常规治疗的基础上治疗1年。主要终点是使用心脏MRI测量的LV收缩末期容积（LVESV）的差异。关键的次要终点包括LV重构的其他指标以及临床和生化参数。结果：在我们的队列中，达格列净对LVESV或任何其他LV重构参数均无影响。然而，它降低了舒张压和袢利尿剂的需求，同时增加了血红蛋白、红细胞压积和酮体。体重有下降的趋势。结论：我们无法确定达格列净在T2 DM合并HF患者中是否对LV重构有任何影响。达格列净在HF中的获益是否是由于重塑或其他机制仍不清楚。
OBJECTIVE 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. RESEARCH DESIGN AND METHODS 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. RESULTS 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. CONCLUSIONS 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.