Effect of Dapagliflozin on Cardiac Structure, Function and Secondary Mitral Regurgitation in Patients with Left Ventricle Dysfunction

NCT ID: NCT05849766

Last Updated: 2024-10-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-27

Study Completion Date

2024-09-01

Brief Summary

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A significant reduction in the incidence of CV death or hospitalization for HF has been observed in randomized trials investigating the CV benefit of Dapagliflozin. Mechanistic investigations are required to interpret the positive clinical effects of Dapagliflozin on heart structure and valvular regurgitation.

Detailed Description

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A functional mitral regurgitation (MR) occurs when the mitral valve (MV) becomes tethered due to abnormal LV remodelling in individuals with heart failure (HF) and left ventricular (LV) dilatation.

The primary treatment for HF is medical, and it is based on established guidelines, as LV failure is the most common cause of secondary functional MR. Standard medical therapy for patients with functional MR, including beta blockers, ACE inhibitors, and angiotensin receptor blockers (ARB), does not reduce the morbidity or mortality associated with these conditions.

Similar to the neprilysin inhibitor, which promotes sodium excretion and has vasodilatory effects via relaxing blood vessels, Dapagliflozin reduce cardiac preload and afterload by inducing natriuresis and reducing arterial stiffness. Effects on blood pressure reduction and weight loss may also positively affect left ventricular (LV) remodelling.

Using echocardiography, researchers hope to test the hypothesis that dapagliflozin improves MR in patients with functional MR due to LV dysfunction. This hypothesis is based on studies showing the beneficial effects of Dapagliflozin on LV modelling.

Conditions

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Dilated Cardiomyopathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control

Group 1 received only standard therapy ACE/ ARB, BB, and diuretics

Group Type PLACEBO_COMPARATOR

Ramipril Tritace®, Carvedilol Carvid®,and Spironolactone Aldactone®

Intervention Type DRUG

Ramipril 10 mg once daily, carvedilol 6.25 mg twice daily and spironolactone 25 once daily

Interventional

Group 2 received dapagliflozin 10 mg once daily in addition to standard therapy ACE/ ARB, BB, and diuretics

Group Type EXPERIMENTAL

Dapagliflozin Farxiga®

Intervention Type DRUG

Dapagliflozin 10 mg once daily

Interventions

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Dapagliflozin Farxiga®

Dapagliflozin 10 mg once daily

Intervention Type DRUG

Ramipril Tritace®, Carvedilol Carvid®,and Spironolactone Aldactone®

Ramipril 10 mg once daily, carvedilol 6.25 mg twice daily and spironolactone 25 once daily

Intervention Type DRUG

Other Intervention Names

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Forxiga Tritace, Carvid, Aldactone

Eligibility Criteria

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Inclusion Criteria

* Outpatients ≥ 18 years of age
* Dilated LV with a reduced ejection fraction and secondary functional MR
* NYHA functional class II or III
* Moderate to Severe MR which lasted \> 6 months under medical treatment with a β-blocker and an ACE inhibitor (or ARB)

Exclusion Criteria

* Current use or prior use of Dapagliflozin
* Current acute heart failure or prior admission with acute decompensated heart failure in 6 months before entry to study
* NYHA functional class IV
* Chronic renal impairment with GFR \< 30 mL/min/1.73m2
* Pregnant or lactating women
* History of allergy to Dapagliflozin
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart Institute, Egypt

OTHER_GOV

Sponsor Role collaborator

University of Florida

OTHER

Sponsor Role collaborator

October 6 University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Essam

Assistant Lecturer of Clinical Pharmacy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed Essam Abou Warda

Role: PRINCIPAL_INVESTIGATOR

October 6 University

Locations

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Beni-suef University

Banī Suwayf, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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IHC00044

Identifier Type: -

Identifier Source: org_study_id

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