Dapagliflozin Effect on Rheumatic Mitral Stenosis (Dapa-Rhemis)

Rheumatic mitral stenosis remains a health problem in developing countries. Progressive fibrosis of the valves and myocardium is the main pathophysiology that plays an important role. Dapagliflozin has various beneficial effects on the heart by reducing fibrosis, reducing inflammation, and improving patient quality of life. However, the role of this therapy is unknown in patients with rheumatic mitral stenosis.

This study is an open-label study on Rheumatic Mitral Stenosis patients, carried out at Sebelas Maret University Hospital Sukoharjo, Panti Rahayu Hospital Purwodadi, and Permata Bunda Hospital Purwodadi. Researchers divided 36 Rheumatic Mitral Stenosis patients sequentially into two groups, the first was the dapagliflozin group which would receive dapagliflozin 10 mg once a day and standard treatment. And the second group will only get standard treatment. Each patient will be examined on PICP, MMP-1, MMP-1/TIMP-1 ratio, TGF-β, Net atrioventricular compliance index, NT-pro BNP, and Kansas City Cardiomyopathy Questionnaire on day 1 and one month after the intervention.

Kansas City Cardiomyopathy Questionnaire (KCCQ) scores are scaled 0-100 (the higher score indicates a better condition)

Inclusion Criteria: Severe mitral stenosis by echocardiographic examination of the planimetric method with morphology that supports the etiology of rheumatic Heart failure in functional class II-III Dapagliflozin naive Exception Criteria: Other significant valve diseases Pregnant or breastfeeding Unstable hemodynamic conditions including cardiogenic shock history of mitral valve replacement/repair or mitral balloon valvuloplasty history of hypoglycemia eGFR below 25 mmHg diffuse pulmonary fibrosis

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