Dapagliflozin-induced integrated improvements in left ventricular diastole, endothelial function, and arterial load: a randomized clinical trial
Authors' conclusion
In patients with T2D at intermediate risk for HFpEF, dapagliflozin was associated with more favorable changes in left ventricular diastolic function parameters compared with glibenclamide, accompanied by improvements in endothelial function and reductions in arterial impedance. These observations support the hypothesis of a vascular-myocardial pathway through which SGLT2 inhibition may exert cardioprotective effects in this population.
Study context
- Population
- Patients with T2D on background metformin; mean age 59 years, 40% female, baseline HbA1c 7.8%, 75% at intermediate risk H2FPEF score
- Participants
- 96 patients
- Comparison
- Dapagliflozin 10 mg vs glibenclamide 5 mg daily for 12 weeks
- Primary endpoint
- Change in E/e'
- Follow-up
- 12 weeks
Methodological detailsprespecified, prospective, open-label, active-controlled
- Prespecified
- Prospective
- Open-label
- Active-controlled
Primary result
As reported in the abstract
Dapagliflozin
- 0.38
mean
Glibenclamide
+ 0.79
mean
Dapagliflozin vs GlibenclamideOdds ratio (95% CI)P value
Odds of higher E/e' quartile; 67% lower likelihood
0.325(0.147–0.715)
P = 0.005- Change in E/e'
- between-group difference - 1.17; P = 0.001
Further findings
Median, %
| Outcome | Dapagliflozin | Glibenclamide | P value |
|---|---|---|---|
| HbA1c change · 12 weeksGlycemic control improved similarly | −0.78 (IQR 0.11) | −0.80 (IQR 0.10) | between-group p = 0.887 |
Correlations of E/e' change with vascular changes (pooled cohort)
- Brachial resistive index change, r (p = 0.005)
- 0.28
- Nitric oxide (NO) bioavailability change, r (p = 0.010)
- - 0.26
- Flow-mediated dilation (FMD) change, r (p = 0.023)
- - 0.23
- No significant correlations for systemic vascular resistance or ventricle-arterial coupling
Original publication
Dapagliflozin-induced integrated improvements in left ventricular diastole, endothelial function, and arterial load: a randomized clinical trial. Cardiovasc Diabetol. Published 26 March 2026. doi:10.
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