: Impact of SGLT-2 inhibitors on congestion and quality of life in decompensated heart failure patients with reduced ejection fraction

Introduction: Heart failure has a high global prevalence and incidence.This is reflected in high morbidity and mortality rates and continues to be a significant challenge, with a high rate of hospitalization and readmission.Objective: To evaluate the impact of iSGLT-2 on volemia, congestion, functionality and quality of life of patients hospitalized with HF functional classes III and IV (NYHA) with reduced ejection fraction.Methods: This was a prospective, interventional study of patients admitted to a tertiary hospital in Curitiba for decompensated heart failure with reduced ejection fraction.The following variables were analyzed: pulmonary, jugular vein and inferior vena cava congestion, quality of life, functionality and laboratory tests assessed on admission, the 15th, 30th, 60th and 90th day after hospital discharge and the start of the drug Dapagliflozin 10 mg, orally, in a single dose for 90 days.Results: The results reflect significant overall improvement in the clinical, ultrasound and laboratory assessment of the patients, with a reduction in clinical symptoms of congestion obtained by the diameter of the vena cava (p<0.03) and in the presence of pulmonary B-lines (p<0.001), as well as increases in the distance covered in the walking test (p<0.001),improvement in O2 saturation (p<0.014) and in the KCCQ-12 score (p<0.001).Conclusions: In the main, there was a significant reduction in pulmonary congestion and global volemia, reflected in the ultrasound improvement and in the patients' quality of life, according to the KCCQ-12.In addition, there was an increase in patient functionality and less dependence for daily tasks, as well as a reduction in blood glucose and NT-Pro-BNP levels, indicating less morbidity and a higher quality of life.