Effect of Dapagliflozin Treatment on Index of Cardiac Electrophysiological Balance in Patients With Heart Failure With Reduced Ejection Fraction

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-08-04 DOI:10.1111/anec.70101

Yusuf Kayhan, Hakan Kaya, Veysi Kavalci, Sabri Abus, Kadir Biyikli, Sezer Markirt, Cemil Can, Erkan Markirt, Deniz Merde Özdemir

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Abstract

Background

Dapagliflozin (DAPA), a sodium-glucose cotransporter-2 (SGLT2) inhibitor, may attenuate the risk of ventricular arrhythmia (VA) through its antiarrhythmic properties in patients with heart failure with reduced ejection fraction (HFrEF). The antiarrhythmic mechanisms of SGLT2 inhibitors are not fully known. Recently, the index of cardiac electrophysiological balance (ICEB) has been posited as a robust indicator for predicting VA risk. ICEB reflects the balance between ventricular depolarization and repolarization. This study was conducted to investigate the effects of DAPA treatment on ICEB in a cohort of patients with HFrEF.

Methods

A total of 235 HFrEF patients undergoing DAPA treatment were enrolled in the study. Each participant underwent a comprehensive 12-lead electrocardiography (ECG) assessment prior to treatment initiation and approximately 6 months posttreatment. ICEB values were compared before and after treatment.

Results

The analysis revealed a statistically significant reduction in the QT interval (427.51 ± 13.87 vs. 347.75 ± 11.21 ms, p < 0.001), corrected QT interval (QTc) (458.34 ± 29.71 vs. 393.37 ± 13.21 ms, p < 0.001), T peak-to-end (Tp-e) interval (85.41 ± 3.52 vs. 71.18 ± 3.16 ms, p < 0.001), Tp-e/QTc ratio (0.186 ± 0.009 vs. 0.180 ± 0.003, p < 0.001), ICEB (4.59 ± 0.65 vs. 3.77 ± 0.15, p < 0.001), following approximately 6 months of DAPA treatment.

Conclusion

In addition to ventricular repolarization distribution indices, the regression of the ICEB values after DAPA treatment in patients with HFrEF shows that DAPA treatment improves the balance between ventricular depolarization and repolarization and reduces the risk of VA in these patients.

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达格列净治疗对心力衰竭伴射血分数降低患者心脏电生理平衡指标的影响

Dapagliflozin （DAPA）是一种钠-葡萄糖共转运蛋白-2 （SGLT2）抑制剂，可能通过其抗心律失常特性降低心力衰竭伴射血分数降低（HFrEF）患者的室性心律失常（VA）风险。SGLT2抑制剂的抗心律失常机制尚不完全清楚。近年来，心脏电生理平衡（ICEB）指标被认为是预测室性心律失常风险的重要指标。ICEB反映了心室去极化和复极化之间的平衡。本研究旨在探讨DAPA治疗对HFrEF患者ICEB的影响。方法对235例接受DAPA治疗的HFrEF患者进行研究。每位参与者在治疗开始前和治疗后约6个月接受了全面的12导联心电图（ECG）评估。比较治疗前后的ICEB值。结果QT间期（427.51±13.87 vs. 347.75±11.21 ms, p < 0.001）、校正QT间期（QTc）（458.34±29.71 vs. 393.37±13.21 ms, p < 0.001）、T峰端（Tp-e）间期（85.41±3.52 vs. 71.18±3.16 ms, p < 0.001）、Tp-e/QTc比值（0.186±0.009 vs. 0.180±0.003,p < 0.001）、icb（4.59±0.65 vs. 3.77±0.15,p < 0.001）、经过大约6个月的DAPA治疗后结论除心室复极分布指数外，对HFrEF患者经DAPA治疗后的ICEB值进行回归分析表明，DAPA治疗改善了患者心室去极化与复极的平衡，降低了患者发生VA的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.