{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:38:21Z","timestamp":1791923901973,"version":"4.3.4"},"reference-count":52,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2022,5,2]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine the impact of sodium-dependent glucose type 2 cotransporter inhibitors on the renal function in acute heart failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a single-centre, controlled, randomised study, patients were prescribed dapagliflozin in addition to standard therapy, or were in receipt of standard therapy. The prespecified outcome was renal function deterioration; the secondary outcomes were the development of resistance to diuretics, weight loss, death during hospitalisation and the rehospitalisation or death for any reason within 30 days following discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>102 patients were included (73.4\u00b111.7 years, 57.8% men). The average left ventricular ejection fraction was 44.9%\u00b114.7%, the average N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was 4706 (1757; 11 244) pg\/mL, the average estimated glomerular filtration rate (eGFR) was 51.6\u00b119.5 mL\/min. eGFR decreased 48 hours after randomisation in the dapagliflozin group (\u22124.2 (\u221211.03; 2.28) mL\/min vs 0.3 (\u22126; 6) mL\/min; p=0.04) but did not differ between the groups on discharge (54.71\u00b119.18 mL\/min and 58.92\u00b124.65 mL\/min; p=0.36). The incidence of worsening renal function did not differ (34.4% vs 15.2%; p=0.07). In the dapagliflozin group, there was less tendency to increase the dose of loop diuretics (14% vs 30%; p=0.048), lower average doses of loop diuretics (78.46\u00b138.95 mg\/day vs 102.82\u00b131.26 mg\/day; p=0.001) and more significant weight loss (4100 (2950; 5750) g vs 3000 (1380; 4650) g; p=0.02). In-hospital mortality was 7.8% (4(8%) in the dapagliflozin and 4 (7.7%) in the control group (p=0.95). The number of deaths within 30 days following discharge in the dapagliflozin group and in the control group was 9 (19%) and 12 (25%), p=0.55; the number of rehospitalisations was 14 (29%) and 17 (35%), respectively (p=0.51).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The use of dapagliflozin was associated with a more pronounced weight loss and less need to increase diuretic therapy without significant deterioration of the renal function. Dapagliflozin did not improve the in-hospital and 30-day prognosis after discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>N04778787.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001936","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T12:18:11Z","timestamp":1653394691000},"page":"e001936","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Impact of dapagliflozin treatment on renal function and diuretics use in acute heart failure: a pilot study"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct04298229","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04363697","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03619213","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7071-5752","authenticated-orcid":false,"given":"Kristina","family":"Charaya","sequence":"first","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Shchekochikhin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Andreev","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Dyachuk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Tarasenko","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Poltavskaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinara","family":"Mesitskaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Bogdanova","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Ananicheva","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Kuzub","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Functional and Ultrasound Diagnostics, Sechenov University, Moskva, Moskva, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"2025081611570445000_9.1.e001936.1","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2016"},{"key":"2025081611570445000_9.1.e001936.2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1159\/000509353","article-title":"Acute cardiorenal syndrome: models and Heart-Kidney connectors","volume":"144","author":"Funahashi","year":"2020","journal-title":"Nephron"},{"key":"2025081611570445000_9.1.e001936.3","doi-asserted-by":"crossref","DOI":"10.3390\/ijms22115863","article-title":"Impact of SGLT2 inhibitors on heart failure: from pathophysiology to clinical effects","volume":"22","author":"Palmiero","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2025081611570445000_9.1.e001936.4","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s00228-021-03147-4","article-title":"Comparing the clinical outcomes across different sodium\/glucose cotransporter 2 (SGLT2) inhibitors in heart failure patients: a systematic review and network meta-analysis of randomized controlled trials","volume":"77","author":"Teo","year":"2021","journal-title":"Eur J Clin Pharmacol"},{"key":"2025081611570445000_9.1.e001936.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.108796","article-title":"Sodium-Glucose transporter inhibition in heart failure: from an unexpected side effect to a novel treatment possibility","volume":"175","author":"Ferrannini","year":"2021","journal-title":"Diabetes Res Clin Pract"},{"key":"2025081611570445000_9.1.e001936.6","first-page":"376","article-title":"The treatment of heart failure with reduced ejection fraction","volume":"117","author":"Berliner","year":"2020","journal-title":"Dtsch Arztebl Int"},{"key":"2025081611570445000_9.1.e001936.7","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1002\/ejhf.1713","article-title":"Randomized, double-blind, placebo-controlled, multicentre pilot study on the effects of empagliflozin on clinical outcomes in patients with acute decompensated heart failure (EMPA-RESPONSE-AHF)","volume":"22","author":"Damman","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2025081611570445000_9.1.e001936.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030183"},{"key":"2025081611570445000_9.1.e001936.9","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.3390\/jcm9072243","article-title":"Nephroprotection by SGLT2 inhibition: back to the future?","volume":"9","author":"De Nicola","year":"2020","journal-title":"J Clin Med"},{"key":"2025081611570445000_9.1.e001936.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.920298"},{"key":"2025081611570445000_9.1.e001936.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.04.008"},{"key":"2025081611570445000_9.1.e001936.12","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2025081611570445000_9.1.e001936.13","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew082"},{"key":"2025081611570445000_9.1.e001936.14","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"2025081611570445000_9.1.e001936.15","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"2025081611570445000_9.1.e001936.16","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1586\/14779072.2015.1087313","article-title":"Unsolved challenges in diuretic therapy for acute heart failure: a focus on diuretic response","volume":"13","author":"Vaduganathan","year":"2015","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2025081611570445000_9.1.e001936.17","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1097\/CCM.0000000000004074","article-title":"A novel patient-specific model for predicting severe oliguria; development and comparison with kidney disease: improving global outcomes acute kidney injury classification","volume":"48","author":"Howitt","year":"2020","journal-title":"Crit Care Med"},{"key":"2025081611570445000_9.1.e001936.18","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.35"},{"key":"2025081611570445000_9.1.e001936.19","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s00134-017-4834-9","article-title":"Diuretics in cardiorenal syndrome: what's new?","volume":"44","author":"Verbrugge","year":"2018","journal-title":"Intensive Care Med"},{"key":"2025081611570445000_9.1.e001936.20","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.ahj.2012.08.019","article-title":"Effect of admission oral diuretic dose on response to continuous versus bolus intravenous diuretics in acute heart failure: an analysis from diuretic optimization strategies in acute heart failure","volume":"164","author":"Shah","year":"2012","journal-title":"Am Heart J"},{"key":"2025081611570445000_9.1.e001936.21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.114.001957"},{"key":"2025081611570445000_9.1.e001936.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.03.009"},{"key":"2025081611570445000_9.1.e001936.23","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft060"},{"key":"2025081611570445000_9.1.e001936.24","doi-asserted-by":"crossref","DOI":"10.1177\/1753944719894509","article-title":"Importance of sodium-glucose cotransporter 2 inhibitor use in diabetic patients with acute heart failure","volume":"13","author":"Kambara","year":"2019","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"2025081611570445000_9.1.e001936.25","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.ahj.2020.10.071","article-title":"Efficacy and safety of dapagliflozin in acute heart failure: rationale and design of the DICTATE-AHF trial","volume":"232","author":"Cox","year":"2021","journal-title":"Am Heart J"},{"key":"2025081611570445000_9.1.e001936.26","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1038\/s41591-021-01659-1","article-title":"The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial","volume":"28","author":"Voors","year":"2022","journal-title":"Nat Med"},{"key":"2025081611570445000_9.1.e001936.27","first-page":"621","article-title":"Evidence-Based management of acute heart failure","volume":"37","author":"Gupta","year":"2021","journal-title":"Can J Cardiol"},{"key":"2025081611570445000_9.1.e001936.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.09.012"},{"key":"2025081611570445000_9.1.e001936.29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1210357"},{"key":"2025081611570445000_9.1.e001936.30","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2022190"},{"key":"2025081611570445000_9.1.e001936.31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"2025081611570445000_9.1.e001936.32","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2024816"},{"key":"2025081611570445000_9.1.e001936.33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1811744"},{"key":"2025081611570445000_9.1.e001936.34","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10741-020-10024-2","article-title":"Renal protection: a leading mechanism for cardiovascular benefit in patients treated with SGLT2 inhibitors","volume":"26","author":"Margonato","year":"2021","journal-title":"Heart Fail Rev"},{"key":"2025081611570445000_9.1.e001936.35","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1146\/annurev-physiol-031620-095920","article-title":"Effects of SGLT2 inhibitors on kidney and cardiovascular function","volume":"83","author":"Vallon","year":"2021","journal-title":"Annu Rev Physiol"},{"key":"2025081611570445000_9.1.e001936.36","doi-asserted-by":"crossref","DOI":"10.3390\/ijms21217833","article-title":"Molecular mechanisms of SGLT2 inhibitor on cardiorenal protection","volume":"21","author":"Hou","year":"2020","journal-title":"Int J Mol Sci"},{"key":"2025081611570445000_9.1.e001936.37","article-title":"Renin\u2013Angiotensin system inhibition, worsening renal function, and outcome in heart failure patients with reduced and preserved ejection fraction","volume":"10","author":"Beldhuis","year":"2017","journal-title":"Circulation"},{"key":"2025081611570445000_9.1.e001936.38","doi-asserted-by":"crossref","DOI":"10.1007\/s11886-020-01384-0","article-title":"Acute cardiorenal syndrome in heart failure: from dogmas to advances","volume":"22","author":"Tang","year":"2020","journal-title":"Curr Cardiol Rep"},{"key":"2025081611570445000_9.1.e001936.39","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1002\/ehf2.12759","article-title":"Sodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series","volume":"7","author":"Griffin","year":"2020","journal-title":"ESC Heart Fail"},{"key":"2025081611570445000_9.1.e001936.40","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1038\/s41569-020-0379-7","article-title":"Congestion in heart failure: a contemporary look at physiology, diagnosis and treatment","volume":"17","author":"Boorsma","year":"2020","journal-title":"Nat Rev Cardiol"},{"key":"2025081611570445000_9.1.e001936.41","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1093\/ehjcvp\/pvaa051","article-title":"The interplay between cardiology and diabetology: a renewed collaboration to optimize cardiovascular prevention and heart failure management","volume":"6","author":"Sabouret","year":"2020","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"2025081611570445000_9.1.e001936.42","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/ejhf.1419","article-title":"Empagliflozin reduces the risk of a broad spectrum of heart failure outcomes regardless of heart failure status at baseline","volume":"21","author":"Januzzi","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2025081611570445000_9.1.e001936.43","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-91546-z","article-title":"Decoding empagliflozin's molecular mechanism of action in heart failure with preserved ejection fraction using artificial intelligence","volume":"11","author":"Bayes-Genis","year":"2021","journal-title":"Sci Rep"},{"key":"2025081611570445000_9.1.e001936.44","article-title":"New antidiabetic therapy and HFpEF: light at the end of tunnel?","author":"Tadic","year":"2021","journal-title":"Heart Fail Rev"},{"key":"2025081611570445000_9.1.e001936.45","doi-asserted-by":"crossref","DOI":"10.15420\/ecr.2021.22","article-title":"Women and diabetes: preventing heart disease in a new era of therapies","volume":"16","author":"Galati","year":"2021","journal-title":"Eur Cardiol"},{"key":"2025081611570445000_9.1.e001936.46","doi-asserted-by":"crossref","unstructured":"Li W , Katamreddy A , Kataria R . Sodium-Glucose cotransporter-2 inhibitor use is associated with a reduced risk of heart failure hospitalization in patients with heart failure with preserved ejection fraction and type 2 diabetes mellitus: a real-world study on a diverse urban population. Drugs Real World Outcomes 2021.doi:10.1007\/s40801-021-00277-0","DOI":"10.1007\/s40801-021-00277-0"},{"key":"2025081611570445000_9.1.e001936.47","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.cardfail.2021.05.012","article-title":"Empagliflozin in heart failure with predicted preserved versus reduced ejection fraction: data from the EMPA-REG outcome trial","volume":"27","author":"Savarese","year":"2021","journal-title":"J Card Fail"},{"key":"2025081611570445000_9.1.e001936.48","article-title":"2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of cardiology Foundation\/American heart association Task force on practice guidelines","volume":"128","author":"Yancy","year":"2013","journal-title":"Circulation"},{"key":"2025081611570445000_9.1.e001936.49","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107038"},{"key":"2025081611570445000_9.1.e001936.50","first-page":"S107100076","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure","volume":"9164","author":"Members","year":"2022","journal-title":"J Card Fail"},{"key":"2025081611570445000_9.1.e001936.51","unstructured":"Us National Institutes of health, 2021. Available: http:\/\/www.clinicaltrials.gov [Accessed 18 Feb 2022]."},{"key":"2025081611570445000_9.1.e001936.52","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1002\/ejhf.2249","article-title":"Dapagliflozin in heart failure with preserved and mildly reduced ejection fraction: rationale and design of the deliver trial","volume":"23","author":"Solomon","year":"2021","journal-title":"Eur J Heart Fail"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2021-001936","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T18:57:19Z","timestamp":1755370639000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2021-001936"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,5,24]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/openhrt-2021-001936"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2021-001936","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}