Effects of SGLT2i on peak VO2 in patients with HFrEF

Short-term effects of dapagliflozin on peak VO2 in heart failure and reduced ejection fraction (DAPA-VO2): a randomized clinical trial

Presented at ESC Heart Failure 2022 by Julio Nunez Villota, MD (Valencia, Spain)

Introduction and methods

SGLT2 inhibitors have been shown to reduce adverse outcomes in patients with HFrEF. Clinical benefits were observed early on, within the first month after initiation of treatment. The current study investigated the effect of dapagliflozin on maximal functional capacity at 1 and 3 months in patients with stable HFrEF.

DAPA-VO2 was a multicenter, randomized, blinded clinical trial. A total of 90 patients with HFrEF (NYHA II-III, LVEF ≤ 40%; NT-proBNP ≥ 600 pg/mL; eGFR ≥ 30 ml/min/1.73m²) were randomized (1:1) to receive either dapagliflozin or placebo in addition to GDMT. Patients underwent cardiopulmonary exercise testing (CPET, bicycle ergometer) at baseline, and at 1 and 3 months after randomization.

The primary outcome was change in peakVO2. Secondary outcomes were change in distance walked in 6MWT, change in the ‘Minnesota Living with Heart Failure Questionnaire (MLHFQ)’, and change in echocardiographic parameters.

Main results

• Mean peakVO2 at baseline was 12.9 ± 3.6 mL/kg/min in patients in the placebo group and 13.4 ± 3.5 mL/kg/min in patients in the dapagliflozin group.
• Mean peakVO2 was higher at 1 month (∆=+1.09; P=0.021) and at 3 months (∆=+1.06; P=0.032) in patients allocated to dapagliflozin compared to patients on placebo.
• No significant differences between treatment groups were found in any of the secondary endpoints.

Conclusion

In patients with HFrEF, treatment with dapagliflozin led to a higher peakVO2 at 1 and 3 months after initiation of treatment, compared to placebo.

– Our coverage of ESC Heart Failure 2022 is based on the information provided during the congress –