TY - JOUR
T1 - Dapagliflozin Reduces Epicardial Adipose Tissue in Patients with Heart Failure and Type 2 Diabetes
AU - Alghamdi, Mohmmad
AU - Dihoum, Adel
AU - Hakami, Khalid
AU - Bhattacharjee, Atanu
AU - Brown, Alexander J. M.
AU - Singh, Jagdeep
AU - Altalabany, Shaween
AU - Lang, Chim
AU - Mordi, Ify
AU - Khan, Faisel
N1 - Publisher Copyright:
© 2025 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Epicardial adipose tissue (EAT) has a contributory role in the progression of heart failure. We tested whether dapagliflozin reduces EAT in adults with type 2 diabetes (T2D) and heart failure and explored links with systemic inflammation and cardiac structure. Methods: This analysis is based on pooled data from two phase 2, single-centre, double-blind, placebo-controlled randomised trials (REFORM and DAPA-LVH) conducted in Scotland. Exactly 122 participants with T2D and stage B or C heart failure were randomised to dapagliflozin 10 mg once daily or placebo for 12 months. Cardiac magnetic resonance imaging (CMR) was used to assess EAT. At baseline and follow-up, the inflammatory markers TNF, IL-1, IL-6, IL-10, and CRP were measured. Results: At baseline, obesity was common (75% with BMI ≥30 kg/m
2) and heart-failure phenotypes were balanced (HFpEF 51%, HFrEF 49%). After 12 months, dapagliflozin significantly reduced EAT independently of changes in BMI (−1.16 ± 0.18 vs. +0.36 ± 0.19 cm
2, p < 0.001), BMI (−1.17 ± 0.16 vs. −0.18 ± 0.17 kg/m
2, p < 0.001), and left ventricular mass (−3.53 ± 1.77 vs. +1.57 ± 1.83 g, p = 0.048) compared with placebo. Conclusion: Dapagliflozin shrinks EAT and LV mass independently of BMI in T2D patients with stage B/C heart failure, supporting EAT as a modifiable target of SGLT2 inhibition. The absence of parallel changes in systemic inflammation suggests primarily local mechanisms.
AB - Background: Epicardial adipose tissue (EAT) has a contributory role in the progression of heart failure. We tested whether dapagliflozin reduces EAT in adults with type 2 diabetes (T2D) and heart failure and explored links with systemic inflammation and cardiac structure. Methods: This analysis is based on pooled data from two phase 2, single-centre, double-blind, placebo-controlled randomised trials (REFORM and DAPA-LVH) conducted in Scotland. Exactly 122 participants with T2D and stage B or C heart failure were randomised to dapagliflozin 10 mg once daily or placebo for 12 months. Cardiac magnetic resonance imaging (CMR) was used to assess EAT. At baseline and follow-up, the inflammatory markers TNF, IL-1, IL-6, IL-10, and CRP were measured. Results: At baseline, obesity was common (75% with BMI ≥30 kg/m
2) and heart-failure phenotypes were balanced (HFpEF 51%, HFrEF 49%). After 12 months, dapagliflozin significantly reduced EAT independently of changes in BMI (−1.16 ± 0.18 vs. +0.36 ± 0.19 cm
2, p < 0.001), BMI (−1.17 ± 0.16 vs. −0.18 ± 0.17 kg/m
2, p < 0.001), and left ventricular mass (−3.53 ± 1.77 vs. +1.57 ± 1.83 g, p = 0.048) compared with placebo. Conclusion: Dapagliflozin shrinks EAT and LV mass independently of BMI in T2D patients with stage B/C heart failure, supporting EAT as a modifiable target of SGLT2 inhibition. The absence of parallel changes in systemic inflammation suggests primarily local mechanisms.
KW - cardiovascular disease
KW - dapagliflozin
KW - effectiveness
KW - heart failure
KW - type 2 diabetes
UR - https://www.scopus.com/pages/publications/105018503602
U2 - 10.1111/dom.70164
DO - 10.1111/dom.70164
M3 - Article
C2 - 41053997
SN - 1462-8902
VL - 27
SP - 7561
EP - 7569
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
IS - 12
ER -
