{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:07:00Z","timestamp":1790838420923,"version":"4.1.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dapagliflozin (DAPA), a sodium-glucose cotransporter-2 inhibitor, has shown promise in adult patients with heart failure (HF), but its safety and efficacy in children remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      In this randomized controlled pilot study, 20 children (aged 1\u201312 years, median 2.2 years, and eight boys) with dilated cardiomyopathy and HF with reduced ejection fraction (HFrEF) were randomized to receive either DAPA plus standard therapy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 9) or standard therapy alone (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11). The primary outcome was a composite of worsening HF, HF hospitalization, and cardiovascular death over a 6-month follow-up period. Secondary outcomes included adverse events, such as changes in renal function, volume status, serum electrolyte levels, blood glucose levels, ketoacidosis, and urinary tract infections. The other secondary efficacy outcomes included N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and changes in functional class from baseline to 6 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The primary composite outcome occurred in three patients: one (cardiovascular death) in the DAPA group and two (cardiovascular death and HF hospitalization) in the control group (11.1% vs. 18.25%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.58). Two patients in the DAPA group developed transient prerenal acute kidney injury. Mild hyponatremia was present in 45% of patients during follow-up, with no significant difference between the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.34). No cases of ketoacidosis or urinary infection were observed in DAPA group. Both the groups demonstrated improvements in NT-proBNP levels and functional class, with no statistically significant differences observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Dapagliflozin was generally well tolerated in children with HFrEF, with a safety profile similar to that of the control group. However, no significant differences were observed in efficacy outcomes between the groups in this pilot study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_188_25","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T13:00:09Z","timestamp":1767272409000},"page":"323-330","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Dapagliflozin in pediatric heart failure with reduced ejection fraction \u2013 A randomized pilot study"],"prefix":"10.4103","volume":"18","author":[{"given":"Nabeel Valappil","family":"Faisal","sequence":"first","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Arumugam","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivaprasad Pannasamudra","family":"Mohankumar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamk","family":"Kadiyani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmy","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudip Kumar","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Lab Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Seth","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Narang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivasubramanian","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1161\/CIRCHEARTFAILURE.108.820217","article-title":"Heart failure in children: Part I: History, etiology, and pathophysiology","volume":"2","author":"Hsu","year":"2009","journal-title":"Circ Heart Fail"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1056\/NEJMoa021715","article-title":"The incidence of pediatric cardiomyopathy in two regions of the United States","volume":"348","author":"Lipshultz","year":"2003","journal-title":"N Engl J 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patients with single ventricle congenital heart disease and fontan circulatory failure","volume":"46","author":"Konduri","year":"2025","journal-title":"Pediatr Cardiol"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/dom.13012","article-title":"Sodium-glucose co-transporter-2 inhibitors and diabetic ketoacidosis: An updated review of the literature","volume":"20","author":"Bonora","year":"2018","journal-title":"Diabetes Obes Metab"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.33963\/v.phj.102194","article-title":"Treatment with dapagliflozin in pediatric patients with heart failure in four different etiologies: A case series","volume":"82","author":"Kurkiewicz-Sawczak","year":"2024","journal-title":"Kardiol Pol"}],"container-title":["Annals of Pediatric 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