Introduction
heart failure, AHF, acute heart failure, decompensation
HEART FAILURE, FLUID OVERLOAD, ACUTE HEART FAILURE, HEART
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the first-line therapy in patients with heart failure with reduced ejection fraction (HFrEF)CA125 is upregulated in most patients with acute heart failure (AHF), and its values identify patients with greater fluid overload and a higher risk of adverse eventsInterestingly, the trajectory of CA125 weeks after decompensation is strongly associated with the risk of adverse eventsThe DAPA-VO2 trial examined the effects of dapagliflozin in 90 stable patients with heart failure with reduced ejection fraction (HFrEF) in New York Heart Association Class (NYHA class) II or III. These patients were randomly assigned to receive either dapagliflozin or placebo. The primary outcome measured the change in peak oxygen consumption (peakVO2) at 1 and 3 months. Main results showed that patients treated with dapagliflozin experienced a significant increase in peakVO2 compared to the 27placebo group at both 1 and 3 months (1-month: + Δ 1.09 ml/kg/min, 95% confidence interval [CI] 0.14–2.04; p = 0.021, and 3-month: + Δ 1.06 ml/kg/min, 95% CI 0.07–2.04; p = 0.032)In this substudy, we aimed to evaluate short-term changes in CA125 after dapagliflozin initiation in patients with HFrEF and whether these changes mediate the effect of dapagliflozin in maximal function capacity assessed by peak oxygen consumption (peakVO