Nada, F., El Merry, M., Abdellah, A. (2025). Effect of Dapagliflozin on Left Atrial Strain Parameters in Diabetic Patients with Paroxysmal Atrial Fibrillation. Suez Canal University Medical Journal, 28(1), 16-27. doi: 10.21608/scumj.2025.416334
Fathy Nada; Mohammed El Merry; Ahmed Abdellah. "Effect of Dapagliflozin on Left Atrial Strain Parameters in Diabetic Patients with Paroxysmal Atrial Fibrillation". Suez Canal University Medical Journal, 28, 1, 2025, 16-27. doi: 10.21608/scumj.2025.416334
Nada, F., El Merry, M., Abdellah, A. (2025). 'Effect of Dapagliflozin on Left Atrial Strain Parameters in Diabetic Patients with Paroxysmal Atrial Fibrillation', Suez Canal University Medical Journal, 28(1), pp. 16-27. doi: 10.21608/scumj.2025.416334
Nada, F., El Merry, M., Abdellah, A. Effect of Dapagliflozin on Left Atrial Strain Parameters in Diabetic Patients with Paroxysmal Atrial Fibrillation. Suez Canal University Medical Journal, 2025; 28(1): 16-27. doi: 10.21608/scumj.2025.416334
Effect of Dapagliflozin on Left Atrial Strain Parameters in Diabetic Patients with Paroxysmal Atrial Fibrillation
Cardiology department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Abstract
Background: Atrial fibrillation (AF) is a common arrythmia in diabetes mellitus (DM). Left atrial strain (LAS) and electromechanical delay (EMD) are important AF predictors. Aim: To investigate the effect of dapagliflozin added to the standard antidiabetic treatment on LAS and EMD in type 2 DM (T2DM) patients with paroxysmal AF. Subjects and Methods: Diabetic patients in sinus rhythm with history of paroxysmal AF diagnosed by Holter electrocardiogram (ECG) or hospitalization were assigned into 2 groups. Dapagliflozin group: dapagliflozin 10 mg added to the standard antidiabetic treatment. Control group: standard antidiabetic treatment without added Sodium-Glucose-Cotransporter inhibitors (SGLT2i). Both groups were on beta blockers to prevent AF recurrence. We assessed baseline characteristics, echocardiography, LAS, EMD, and paroxysmal AF prevalence in both groups. Results: Dapagliflozin group (113 patients) has a postive improvement in diastolic function (E/e’ reduced from 9.9±2.4 to 7.8±1.8, P< 0.01), LA reservoir strain (26.5±7.9% to 28.9±3.8%, P< 0.015), LA contraction strain (10.8±4.9% to 12.2±5.9%, P< 0.021), and interatrial EMD (29.75±7.53 to 21.72±4.51 milliseconds, P< 0.029) at 12-months follow-up. Likewise, paroxysmal AF has occurred in 7.1% of dapagliflozin group vs 13.8% in control group at 12-months follow-up, P value Conclusion: Dapagliflozin addition to the standard antidiabetic treatment was associated with reduction of LA strain and interatrial electromechanical delay in type 2 DM patients who have paroxysmal AF. Moreover, this was associated with reduction of paroxysmal AF recurrence as documented by Holter ECG or hospitalization.
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