Analysis of dapagliflozin combination therapy in heart failure with reduced ejection fraction and its correlation with inflammatory markers.

OBJECTIVE: To investigate the effects of the sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin on myocardial function, inflammatory markers, and cardiovascular outcomes in patients with heart failure with reduced ejection fraction (HFrEF). METHODS: A retrospective analysis was conducted on 107 hospitalized patients with HFrEF treated at our hospital between November 2022 and October 2024. Based on the treatment regimen, patients were divided into a control group (n = 52), which received standard therapy [diuretics, β-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and aldosterone antagonists], or into a dapagliflozin group (n = 55), which received dapagliflozin in addition to standard therapy. Outcomes assessed included: clinical efficacy; cardiac function [left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and left ventricular ejection fraction (LVEF)]; myocardial work indices [global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE)]; energy metabolism [free fatty acids (FFA) and β-hydroxybutyric acid (β-HB)], inflammatory markers [interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), and IL-10]; quality of life, and the incidence of cardiovascular and other adverse reactions. RESULTS: The dapagliflozin group achieved a significantly higher overall clinical efficacy rate than the control group (94.55% vs. 80.77%; P < 0.05). After 8 weeks of treatment, patients receiving dapagliflozin in addition to standard therapy showed significantly greater improvements in multiple cardiac function parameters compared to those receiving standard therapy alone (P < 0.05). GWI, GCW, and GWE were significantly higher, and GWW significantly lower, in the dapagliflozin group (P < 0.05). Indicators of energy metabolism were significantly higher in the dapagliflozin group (P < 0.05). Pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) decreased, whereas the anti-inflammatory cytokine IL-10 increased more markedly in the dapagliflozin group compared to the control group (P < 0.05). After treatment, the dapagliflozin group showed greater improvements across multiple quality-of-life dimensions, and significantly lower incidence of cardiovascular adverse events (14.55% vs. 34.62%) (P < 0.05). The overall incidence of other adverse reactions did not differ significantly between groups (P > 0.05). CONCLUSION: In patients with HFrEF, the addition of dapagliflozin to standard therapy provides synergistic benefits in improving cardiac function, energy metabolism, and inflammatory status. These effects translate into improved quality of life and cardiovascular outcomes, highlighting dapagliflozin's clinical value in this population.