Influence of dapagliflozin on cardiac diastolic function and peripheral blood biomarkers of inflammation and myocardial function in elderly patients with heart failure with preserved ejection fraction
CAI Yiqun
LI Shaoke
LIU Bo
XUAN Xuexi
Abstract：Objective To observe the influence of dapagliflozin on cardiac diastolic function and peripheral blood biomarkers of inflammation and myocardial function in elderly patients with heart failure with preserved ejection fraction(HFpEF).Methods HFpEF patients(n=120)were selected and divided into guideline group and combination group(each n=60)by using random digital table in the Zhengzhou Seventh People's Hospital from Jan.2021 to June 2022.The guideline group was given routine medication,and combination group was additionally given dapagliflozin.The cardiac diastolic function,inflammatory response indicators[microRNA-146a(miR-146a),interleukin 1 receptor-associated kinase 1(IRAK-1),tumor necrosis factor-α(TNF-α)],myocardial function indicators[N-terminal brain natriuretic peptide precursor(NT-proBNP),microtubule junction protein(Nexilin)],and scores of Minnesota Living with Heart Failure Questionnaire(MLHFQ)were compared between 2 groups before treatment and after treatment for 6 months.The incidence of adverse reactions and major adverse cardiovascular and cerebrovascular events(MACCE)were statistically analyzed in 2 groups.Results Before treatment,the comparison in cardiac diastolic function showed the difference had no statistical significance between 2 groups(P>0.050).After treatment for 6 months,left ventricular ejection fraction(LVEF)increased in 2 groups,which was higher in combination group than that in guideline group(P<0.050).The left ventricular mass index(LVMI),left atrial volume index(LAVI),and ratio of peak value of mitral valve flow spectrum E to peak value of maximum mitral ring movement E'in early diastolic period(E/e')decreased in 2 groups,which were lower in combination group than those in guideline group(P<0.050).The comparison in inflammatory response indicators showed the difference had no statistical significance between 2 groups before treatment(P>0.050).After treatment for 6 months,IRAK-1 increased,and miR-146a and TNF-α decreased in 2 groups(P<0.05),while IRAK-1 was higher,and miR-146a and TNF-α were lower in combination group than those in guideline group(P<0.05).The comparison in myocardial function indicators showed the difference had no statistical significance between 2 groups before treatment(P>0.050).After treatment for 6 months,NT-proBNP and Nexilin decreased in 2 groups(P<0.05),while NT-proBNP and Nexilin were lower in combination group than those in guideline group(P<0.050).The comparison in MLHFQ scores showed the difference had no statistical significance between 2 groups before treatment(P>0.050).After treatment for 6 months,MLHFQ scores decreased,while MLHFQ scores were lower in combination group than those in guideline group(P<0.050).The incidence of urinary tract infections was higher in combination group than that in guideline group(11.67%vs.1.67%).The incidence of MACCE was lower in combination group than that in guideline group(8.33%vs.20.00%,P>0.050).Conclusion Dapagliflozin can improve cardiac diastolic function in elderly HFpEF patients,regulate the expressions of peripheral blood inflammatory indicators(miR-146a,IRAK-1,TNF-α)and myocardial function indicators(NT-proBNP,Nexilin).It may increase the risk of urinary tract infections,thus close monitoring and preventive measures are required for populations at high risk of urinary tract infections in clinical practice.
Keywords：dapagliflozinheart failure with preserved ejection fractionagednesscardiac diastolic functionsafetymajor adverse cardiovascular and cerebrovascular events
Publication Date：2026-02-20
Online Publishing Date：2026-03-19(First online date of this platform, not the publication date of the document)
Pages：6( 184-188,194 )