الفهرس 
Acute heart failureOnly 14 pages are availabe for public view
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Abstract
Heart failure (HF) with reduced ejection fraction (HFrEF) remains a challenging problem due to its high mortality rate. A recent study evaluated the potency of dapagliflozin in terms of mortality and deterioration of HF, in patients taking sacubitril/valsartan and in patients who were naive..
Dapagliflozin produces a diuretic action by inducing fluid loss from the intravascular compartment, which is highly beneficial in patients with HF, as it has no effect on reducing intravascular pressure, i.e. systolic ABP. Another key aspect is related to the positive impact of SGLT-2 inhibitors on myocardial energetics. SGLT2 inhibitors increase the production of ketone bodies and enhance their utilisation in the heart, which improves the energy metabolism of cardiomyocytes, and thus reduces the risk of HF development and recurrence. Also, inhibition of the unfavourable process of cardiac remodelling has been observed.
So, the aim of this study was to study the effects of using dapagliflozin treatment for patient presenting with Acute heart failure with reduced ejection fraction on morbidity and mortality and compare them with patients on conventional treatment only.
In this randomized, controlled trial involving patients with heart failure and a reduced left ventricular ejection fraction, the risk of the primary composite outcome of worsening heart failure (hospitalization) or death from cardiovascular causes was lower in the dapagliflozin group than in the placebo group. Each of these outcomes were less common in the dapagliflozin group, as were the total numbers of hospitalizations for heart failure and deaths from cardiovascular causes. The use of dapagliflozin also resulted in more improvement in cardiac function. The observed benefits, which were substantial and clinically significant, occurred early after randomization and were seen in patients who were receiving other recommended therapies for heart failure.
The assessment of left ventrricular parameters at discharge. LVESD, LVEDD, PWD, IVS, LV mass, E , A, E/A ratio and E/e` ratio were lower among Dapagliflozin group than placebo group with statistical insignificant differences between both groups as p>0.05, while EF was higher among Dapagliflozin group than placebo group with statistical insignificant difference between both groups as p>0.05.
The assessment of left atrial parameters at discharge. LAD, LA area, LA volume, and LA volume index were lower among Dapagliflozin group than placebo group with statistical insignificant differences between both groups as p>0.05.