Does Dapagliflozin Regress Left Ventricular Hypertrophy in Patients With Type 2 Diabetes? - DAPA-LVH

Jul 17, 2020
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Author/Summarized by Author:
Anthony A. Bavry, MD,MPH,FACC
Summary Reviewer:
Anthony A. Bavry, MD,MPH,FACC
Trial Sponsor:
AstraZeneca
Date Published:
06/24/2020
Original Posted Date:
07/17/2020
References

Contribution To Literature:

The DAPA-LVH trial showed that dapagliflozin was superior to placebo at promoting reverse LV remodeling.

Description:

The goal of the trial was to evaluate the sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin compared with placebo among participants with diabetes and left ventricular hypertrophy (LVH).

Study Design

  • Randomized
  • Parallel

Participants with diabetes and LVH were randomized to dapagliflozin (n = 32) versus placebo (n = 34).

  • Total number of enrollees: 66
  • Duration of follow-up: 12 months
  • Mean patient age: 67 years
  • Percentage female: 42%
  • Percentage with diabetes: 100%

Inclusion criteria:

  • Participants 18-80 years of age
  • Type 2 diabetes
  • LVH (either LV mass index of >115 g/m2 for men and >95 g/m2 for women indexed to body surface area or >48 g/m2.7 or 44 g/m2.7 when indexed to height)
  • Controlled hypertension (<145/90 mm Hg)

Principal Findings:

The primary outcome, change in absolute LV mass at 12 months, was -3.95 ± 4.85 g in the dapagliflozin group compared with -1.13 ± 4.55 g in the placebo group (p = 0.018).

Secondary outcomes:

  • Change in 24-hour systolic blood pressure at 12 months: -2.78 mm Hg in the dapagliflozin group compared with 0.85 mm Hg in the placebo group (p = 0.012)
  • Change in weight at 12 months: -4.27 kg in the dapagliflozin group compared with -0.50 kg in the placebo group (p < 0.001)

Interpretation:

Among patients with diabetes and LVH, dapagliflozin was associated with a reduction in LVH at 12 months compared to placebo. Dapagliflozin was also associated with reductions in systolic blood pressure and body weight. These findings may help to explain the cardioprotective effects of this class of medication.

References:

Brown AJ, Gandy S, McCrimmon R, Houston JG, Struthers AD, Lang CC. A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type two diabetes: the DAPA-LVH trial. Eur Heart J 2020;Jun 24:[Epub ahead of print].

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Lipid Metabolism, Acute Heart Failure, Hypertension

Keywords: Blood Pressure, Body Surface Area, Body Weight, Diabetes Mellitus, Diabetes Mellitus, Type 2, Glucosides, Heart Failure, Hypertension, Hypertrophy, Left Ventricular, Metabolic Syndrome, Secondary Prevention, Sodium-Glucose Transporter 2


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