Dapagliflozin effects on lung fluid volumes in patients with heart failure and reduced ejection fraction: results from the DEFINE‐HF Trial.

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been shown to reduce the risk of CV death or worsening heart failure, improve symptom burden, physical function and quality of life in patients with heart failure and reduced ejection fraction. The mechanisms of HF benefits of SGLT-2is, however, remains unclear. In this substudy of the DEFINE-HF trial, patients randomized to dapagliflozin or placebo had lung fluid volumes measured by remote dieletric sensing at baseline and after twelve weeks of therapy. A significantly greater proportion of dapagliflozin-treated patients (as compared with placebo) experienced improvement in lung fluid volumes and fewer dapagliflozin-treated patients had no change or deterioration in lung fluid volumes after 12 weeks of treatment. To our knowledge, this is the first study to suggest a direct effect of dapagliflozin (or any SGLT2i) on more effective "decongestion", contributing in a meaningful way to the ongoing debate regarding the mechanisms of SGLT2i HF benefits. This article is protected by copyright. All rights reserved.