Effect of Dapagliflozin on Right Ventricular-Pulmonary Artery Coupling After Off-Pump Coronary Atery Bypass Grafting

Summary

This prospective, single-center observational study evaluates the effect of dapagliflozin 10 mg/day on right ventricular-pulmonary artery coupling measured by the TAPSE/PASP ratio in 72 patients with left ventricular ejection fraction \<50% after off-pump coronary artery bypass grafting (OPCAB). The primary outcome is the change in TAPSE/PASP ratio from 1 month after surgery (before dapagliflozin) to 7 months after surgery (after 6 months of dapagliflozin therapy).

Eligibility

Inclusion Criteria:

* Age ≥ 18 years
* Elective isolated off-pump coronary artery bypass grafting (OPCAB)
* Left ventricular ejection fraction (LVEF) \< 50% documented on pre-operative echocardiography
* Written informed consent

Exclusion Criteria:

* Concomitant valve surgery
* Emergency or urgent CABG
* Conversion to on-pump during surgery
* Perioperative myocardial infarction (as defined by the Fourth Universal Definition of MI)
* Cardiogenic shock
* More than moderate valvular heart disease
* Persistent atrial fibrillation or atrial flutter at the time of echocardiographic examination)
* Previous CABG or any prior cardiac surgery
* Severe chronic kidney disease (eGFR \< 25 mL/min/1.73 m²)
* Contraindication to SGLT2 inhibitors
* Inability to obtain adequate echocardiographic windows
* Pregnancy or breastfeeding

Conditions3

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