Impact of Dapagliflozin on Left Ventricular Longitudinal Global Strain and Diastolic Function in Non-Diabetic Patients with Heart Failure with Preserved Ejection Fraction

Background: Heart failure (HF) affects around 64.3 million individuals worldwide. HF with preserved ejection fraction (HFpEF) makes up 40–60% of cases and is linked to elevated death and morbidity, Aim: This study aimed to measure the influence of Dapagliflozin on left ventricular diastolic function and global longitudinal strain in non-diabetic cases with heart failure with preserved ejection fraction. Patients and methods: This interventional investigation has been carried out at the Cardiology Clinic, Suez Canal University Hospitals. Cases have been separated into two groups: Group A received guideline-directed medical therapy (GDMT) plus dapagliflozin (n=45), and group B received GDMT alone (n=45).
Results: At three-month follow-up, the dapagliflozin-treated group showed significant improvement in several echocardiographic parameters. Global longitudinal strain (GLS) improved by 10% (p-value under 0.001), left atrial volume index decreased by 14.5% (p-value equal 0.001), and average E/e′ ratio declined by 14.1% (p-value equal 0.001). Enhancements were also noted in deceleration time (28.8%, p=0.005), isovolumic relaxation time (12.6%, p=0.05), tricuspid regurgitation velocity (−10.3%, p < 0.001), pulmonary vein S/D ratio (+10.6%, p < 0.001), and Ar wave (−4.7%, p-value under 0.001). Left ventricular ejection fraction (LVEF) elevated by 1.3% but wasn’t significant (p=0.3). In comparison with the control group, changes in GLS, LA volume, E/e′, and diastolic indices were significantly better in the dapagliflozin group.
Conclusion: Dapagliflozin may benefit non-diabetic HFpEF patients by improving diastolic function and reducing congestion, potentially leading to better outcomes. Echocardiography remains essential for both diagnosis and monitoring treatment response.