In this position paper, by the Heart Failure Association (HFA) of the ESC, clinical trial findings are summarized and treatment of HF with SGLT2i is discussed. Furthermore, potential biological mechanisms and effects of SGLT2i in HF are described. This present position paper extends the 2019 documents.

SGLT2 inhibitors have shown beneficial effects on hospitalization for HF, demonstrated in CV outcomes trials in T2DM patients over the last decade. More recently, the DAPA-HF trial showed reduction of worsening HF or death from CV causes by dapagliflozin compared to placebo in patients with chronic HF with reduced ejection fraction (HFrEF), with or without T2DM. Additional trials are ongoing or about to report their finding on SGLT2i treatment in HFrEF patients or patient with preserved ejection fraction (HFpEF).

Find the position paper online at Eur Heart J