To explore the cardiovascular protective effect of dapagliflozin on patients with heart failure with preserved ejection fraction (HFpEF) complicated with type 2 diabetes mellitus (T2DM).

Patients with HFpEF complicated with T2DM were divided into treatment group and control group according to cohort method. The control group was given 0.5 g of metformin hydrochloride tablet orally twice a day, while the treatment group was given 10 mg of dapagliflozin tablet orally once a day on the basis of treatment in the control group. Patients in both groups were continuously treated for 6 months. The clinical efficacy after treatment and blood glucose indicators [fasting blood glucose (FBG), 2 hours postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA1c)], echocardiographic left ventricular parameters [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular remodeling index (LVRI), left ventricular mass index (LVMI)] and serum N-terminal pro-brain natriuretic peptide (NT-proBNP), serum myocardial fibrosis indicators [matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1)] before and after treatment were compared between both groups, and the safety evaluation was performed.

Seventy-five cases in treatment group and 72 cases in control group were included. After treatment, the total effective rates in treatment group and control group were 93.33% (70 cases/75 cases) and 81.94% (59 cases/72 cases), respectively (P<0.05). After treatment, the levels of FBG, 2 h PBG, HbA1c, LVEF and LVEDD revealed no statistical differences between treatment group and control group (all P>0.05). After treatment, LVRI values in treatment group and control group were (2.17±0.41) and (2.54±0.46) g·mL^-2; LAMI values were (102.47±10.32) and (113.84±15.52) g·m^-2; serum NT-proBNP levels were (652.38±208.26) and (993.24±302.69) pg·mL^-1; MMP-9 levels were (142.52±21.67) and (168.73±25.88) mg·L^-1; TIMP-1 levels were (3.68±0.84) and (3.12±0.91) μg·L^-1, respectively (all P<0.05). The total incidence rates of adverse reactions in treatment group and control group were 14.67% (11 cases/75 cases) and 12.50% (9 cases/72 cases), respectively (P>0.05).

Dapagliflozin can improve ventricular remodeling and enhance cardiac function in patients with HFpEF complicated with T2DM, and it has a significant cardiovascular protective effect.