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Effect of dapagliflozin on ventricular repolarization in patients with heart failure with reduced ejection fraction

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Abstract

Whether sodium–glucose cotransporter-2 inhibitors (SGLT2is) reduce ventricular arrhythmias and sudden cardiac death is controversial. Ventricular repolarization heterogeneity is associated with ventricular arrhythmias; however, the effect of SGLT2is on ventricular repolarization in patients with heart failure with reduced ejection fraction (HFrEF) has not been fully investigated. We prospectively evaluated 31 HFrEF patients in sinus rhythm who were newly started on dapagliflozin 10 mg/day. Changes in QT interval, corrected QT interval (QTc), QT dispersion (QTD), corrected QTD (QTcD), T peak to T end (TpTe), TpTe/QT ratio, and TpTe/QTc ratio were evaluated at 1-year follow-up. QT interval, QTc interval, QTD, QTcD, TpTe, and TpTe/QTc ratio decreased significantly at 1-year follow-up (427.6 ± 52.6 ms vs. 415.4 ± 35.1 ms; p = 0.047, 437.1 ± 37.3 ms vs. 425.6 ± 22.7 ms; p = 0.019, 54.1 ± 11.8 ms vs. 47.6 ± 14.7 ms; p = 0.003, 56.0 ± 11.2 ms vs. 49.4 ± 12.3 ms; p = 0.004, 98.0 ± 15.6 ms vs. 85.5 ± 20.9 ms; p = 0.018, and 0.225 ± 0.035 vs. 0.202 ± 0.051; p = 0.044, respectively). TpTe/QT ratio did not change significantly (0.231 ± 0.040 vs. 0.208 ± 0.054; p = 0.052). QT interval, QTD, and TpTe were significantly reduced 1 year after dapagliflozin treatment in patients with HFrEF. The beneficial effect of dapagliflozin on the heterogeneity of ventricular repolarization may contribute to the suppression of ventricular arrhythmias.

Registry information https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049428. Registry number: UMIN000044902.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Division of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-ku, Tokyo, 101-8643, Japan

    Masaaki Nakase, Kazuyuki Yahagi, Yu Horiuchi, Masahiko Asami, Hitomi Yuzawa, Kota Komiyama, Jun Tanaka, Jiro Aoki & Kengo Tanabe

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  1. Masaaki Nakase
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  2. Kazuyuki Yahagi
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Correspondence to Kazuyuki Yahagi.

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Conflict of interest

Dr. Tanabe receives lecture fee from Astellas Pharma, Kowa Company, Mitsubishi Tanabe Pharma Corporation, Nihon Boehringer Ingelheim, and Ono pharmaceutical. Dr. Aoki receives lecture fee from Astellas Pharma, Kowa Company, Daiichi Sankyo Company, and Nihon Boehringer Ingelheim. Dr. Tanaka receives lecture fee from AstraZeneca, Daiichi Sankyo Company, and Nihon Boehringer Ingelheim. Dr. Komiyama receives lecture fee from Daiichi Sankyo Company and Kowa Company. Dr. Yuzawa receives lecture fee from Daiichi Sankyo Company. Dr. Yahagi receives lecture fee from Daiichi Sankyo Company, Nihon Boehringer Ingelheim, and Fukuda Denshi. Dr. Asami receives lecture fee from AstraZeneca, Astellas Pharma, Daiichi Sankyo Company, and Nihon Boehringer Ingelheim. Dr. Horiuchi receives lecture fee from AstraZeneca and Nihon Boehringer Ingelheim. The remaining author report no conflicts of interest.

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Nakase, M., Yahagi, K., Horiuchi, Y. et al. Effect of dapagliflozin on ventricular repolarization in patients with heart failure with reduced ejection fraction. Heart Vessels 38, 1414–1421 (2023). https://doi.org/10.1007/s00380-023-02298-x

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