부산대학교 도서관

Background: Patients with heart failure and reduced ejection fraction (HFrEF) suffer limitations in physical and social activities. We examined whether the SGLT2 inhibitor dapagliflozin improved the degree of physical and social activity limitation measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ) in DAPA-HF.Hypothesis: Dapagliflozin, compared with placebo, would reduce the limitations of physical and social activity experienced by patients with HFrEF.Methods: We examined the effect of dapagliflozin on the physical and social limitation domains of the KCCQ at 8 months (prespecified analysis time point). Mean change from baseline was calculated using a linear regression model adjusted for baseline values with no imputation for missing data. Scores range from 0-100, with higher scores indicating better health status.Findings: At baseline, 4443 (94%) patients had available KCCQ data. Mean baseline physical limitations and social limitations scores were 66.0±24.0 and 65.5±27.4, respectively. Of the 10 individual domains that constitute these scores, the greatest limitations reported by patients at baseline were in doing gardening or housework or carrying groceries, hurrying/jogging and sexual relationships. Dapagliflozin improved physical and social limitations scores at 8 months (placebo-corrected mean difference +1.88 [95%CI 0.66,3.10] and +1.60 [0.18,3.01], respectively). Each individual domain reflecting physical and social limitations improved with dapagliflozin with the exception of sexual relationships (Table); the greatest improvements were seen in doing gardening or housework or carrying groceries (+2.48 [0.63,4.33]), hobbies and recreational activities (+2.46 [0.75-4.17]), and walking 100yd on level ground (+2.29 [0.62,3.96]).Interpretation: In DAPA-HF, dapagliflozin, compared with placebo, improved physical and social limitations as measured by the KCCQ in patients with HFrEF.