The Effects of SGLTi on Diabetic Cardiomyopathy

Launched by THE UNIVERSITY OF HONG KONG · Dec 12, 2019

Keywords

ClinConnect Summary

Diabetic cardiomyopathy is defined as ventricular dysfunction in diabetic patients in the absence of coronary artery disease and hypertension. It is considered as a cardiac muscle disorder due to the metabolic consequences of DM characterized by left ventricular hypertrophy, left ventricular diastolic dysfunction (in the early stage), and/or systolic dysfunction. To date, there is no specific treatment proven effective for the condition due to the incomplete understanding of the pathogenesis.

Recent studies however prove the efficacy of SGLT-2 inhibitors on reducing the primary composite e...

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Eligibility criteria

• Inclusion Criteria:
• • type 2 diabetes
• • 40-90 years old
• • HbA1c \>= 6.5%
• • history of heart failure with reduced ejection fraction
• • indications for SGLT inhibition on clinical ground
• Exclusion Criteria:
• • angina pectoris or chest discomfort
• • prior coronary artery bypass grafts
• • coronary artery stenting within 6 months of study enrolment
• • pervious myocardial infarct
• • any contraindication for stress CMR testing
• • renal impairment with eGFR \<45ml/min/1.73m2
• • limited life expectancy \<5 years, for example due to pulmonary disease, cancer or
• • significant hepatic failure
• • contraindication to dapagliflozin or other SGLT2 inhibitors
• • unable to take dapagliflozin
• • patients currently on and SGLT2 inhibitor
• • planned need for concomitant cardiac surgery or coronary intervention
• • refusal or inability to sign an informed consent
• • potential for on-compliance towards the requirements in the trial protocol (especially the medical treatment) or follow-up visits