Background: Heart failure is the most common cause of hospitalization in elderly
patients. It is likely that many of the mechanisms that contribute to reductions in
systolic and diastolic function, seen in diabetic patients, place them at an increased
risk of heart failure. Diuretic therapy, especially loop diuretics, is the usual way of
managing congestion, particularly in volume-overloaded patients. Little is known about
the beneficial effect of dapagliflozin when added to loop diuretics in managing patients
with decompensated heart failure.
Aim: To assess the effect of the addition of dapagliflozin to furosemide in managing
decompensated patient with heart failure and reduced left ventricular ejection fraction in
terms of weight loss and dyspnea improvement.
Patients and Methods: The study included 100 type 2 diabetic patients who were
admitted with decompensated heart failure. The study population was randomly divided
into two arms. Serum electrolytes and kidney functions were followed up during their
hospital stay.
Results: With dapagliflozin, there was a statistically significant difference between the
two groups regarding the change in body weight and body mass index. The diuresis
parameters including urine output, total fluid loss, and fluid balance also showed a
statistically significant difference in favor of the use of dapagliflozin, with no significant
change in serum potassium or kidney functions. There was significant improvement in
patient-reported dyspnea scores with the use of dapagliflozin.
Conclusions: Dapagliflozin may provide a new drug option in the
treatment of heart failure especially among vulnerable group of diabetics.