The effect of Dapagliflozin in the 6-minute walk test of patients with Heart Failure with preserved EF

Heart failure with preserved ejection fraction is a clinical syndrome associated with a significant functional limitation.

No treatment has yet been found to improve exercise performance in these patients.

In a recent randomized study including 289 HFpEF patients, it was demonstrated that patients receiving dapagliflozin after a 12 week-period exhibited an improvement in 6MWT by 15 meters compared to placebo. The beneficial response to dapagliflozin was consistent across all pre-specified subgroups.

Dapagliflozin, and possibly other SGLT-2 agents, should be strongly considered in patients with HFpEF, in order to enhance their functional capacity and quality of life.

Circulation: Heart Failure
Effect of Dapagliflozin on 6-Minute Walk Distance in Heart Failure With Preserved Ejection Fraction:
Circ Heart Fail 2023 Oct 23;[EPub Ahead of Print], GD Lewis, K Gosch, LP Cohen, ME Nassif, SL Windsor,
BA Borlaug, DW Kitzman, SJ Shah, T Khumri, G Umpierrez, S Lamba, K Sharma, SS Khan, MN Kosiborod,
AJ Sauer


Smoking cessation after percutaneous coronary intervention (PCI)

Smoking is one of the most harmful habits for our health. This appears to be even more pronounced after a coronary intervention (PCI).

In a population-based retrospective cohort study involving 74,471 patients who underwent PCI, smokers had a nearly 20% higher rate of recurrent major adverse cardiovascular and cerebrovascular events compared with nonsmokers during a median follow-up period of 4 years.

A rather optimistic finding of this study, for smokers, is that in case of successful cessation after PCI there is a substantial reduction of risk which approximates the corresponding risk of non-smokers.

These findings amplify the importance of smoking cessation, especially after a coronary intervention.

European Heart Journal
Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study
Eur Heart J 2023 Sep 26; YJ Ki, K Han, HS Kim, JK Han


Daily step count: how much is enough?

Physical activity is well known to be beneficial for the cardiovascular system, and good health in general. A recent publication addresses the issue of daily step count and how it affects our health.

According to the authors if an individual walks more than 2517 steps per day, a substantial reduction of overall mortality is achieved which reaches 8%.

The benefit of physical movement is increased even more if the daily step count exceeds 8763 steps per day, with the overall mortality to be reduced by 60%. A person who walks 7126 steps per day reduces the risk of any cardiovascular event by 51%.

There is no medication or supplement that can reduce mortality and cardiovascular risk that much. With the use of smartphones and smartwatches it is now very easy to monitor our daily step count. By reaching the numbers, mentioned above, we can easily and effectively protect our health.

Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events
Niels A. Stens, Esmée A. Bakker, Asier Mañas, Laurien M. Buffart, Francisco B. Ortega, Duck-chul Lee,
Paul D. Thompson, Dick H.J. Thijssen, and Thijs M.H. Eijsvogels
J Am Coll Cardiol. 2023 Oct, 82 (15) 1483–1494

People often start a diet in order to lose weight, reduce their cholesterol levels and maintain good health. Diets that are low in fat consumption are in general perceived as the most beneficial for optimal weight control and reduction of cardiovascular risk. However, a very recently published article comes to abolish this theory.

According to this study, 148 individuals without previous history of diabetes or cardiovascular disease were randomized into either low-carbohydrate or low-fat diet.

After one year of observation, a significant weight reduction was identified in the low-carbohydrate diet group (mean reduction 3.5 Kg). Also, the same group demonstrated a significant reduction of CRP, which is known to be a marker of inflammation that is positively correlated with the risk of cardiovascular events. Arterial pressure, glucose and cholesterol levels were similar in both groups.

Diets with low consumption of carbohydrates were initially introduced in the 70s (Atkins diet). However many people argued about the beneficial effect of this particular form of diet. In fact, it was suggested to increase the cardiovascular risk despite reduction of body weight.

Carbohydrates are the main source of energy and constitute a significant proportion of our daily meals (bread, cereals, potatoes, rise, pasta and fruits). Complex carbohydrates (whole grain bread and starchy vegetables) are those that require specific process and sugar is slowly digested and absorbed. Simple carbohydrates (table sugar, soft drinks, candy and white bread) are established to have a low nutritional value and cause an accumulation of fat in the body.

As a conclusion, a diet with a low consumption of carbohydrates is established to produce a significant reduction in body weight without the previous deleterious effects that were previously suggested. However, more research and a longer follow-up are required in order to safely apply such a notion in our everyday life.



Annals of Internal Medicine

Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Bazzano LA

Scientific research often produces controversial results and this causes confusion. Such debatable data are recorded regarding the effect of alcohol consumption on the heart.

A relatively clear orientation is given by a recent review article. According to the author:

Habitual light to moderate consumption of alcohol is beneficial to the heart

  1. The recommended dosage is 1 drink per day for women and 1-2 drinks per day for men
  2. The preferred drink is red wine due to its anti-oxidant effect
  3. The suggested time of drinking is during dinner, since this has recorded the strongest reduction in cardiovascular events

However, caution is required in the following circumstances:

  1. Males aged 15-59 are the most susceptible in excessive consumption of alcohol, which is strongly interrelated with a negative effect (violent behavior, accidents, arterial hypertension, diabetes, cardiovascular events)
  2. Health care professionals should not recommend alcohol to non-drinkers because of the potential for drinking problem, even among individuals at apparently low risk.
  3. Unfortunately consumption is strongly correlated with smoking, which should be strongly discouraged.

The findings of this study were based on a systematic literature search (1997-2012).



Alcohol and cardiovascular health: the dose makes the poison…or the remedy.

Mayo Clin Proc.2014 Mar;89:382-393

O’Keefe JH


Είναι αδύνατο να ξέρει την ιατρική, αυτός που δεν ξέρει ακριβώς τι είναι ο άνθρωπος. ΙΠΠΟΚΡΑΤΗΣ


It is impossible for one to know medicine if he doesn’t know what a human being is. HIPPOCRATES

Copyright by Dr Yiannis Panayiotides 2018. All rights reserved.

Copyright by Dr Yiannis Panayiotides 2018. All rights reserved.