MANUSCRIPT TITLE: AN UPDATE ON CURRENT USAGE OF SGLT2-INHIBITORS IN HEART FAILURE WITH REDUCED EJECTION FRACTION: SPECIAL FOCUS ON DAPAGLIFLOZIN -

Heart failure (HF) is a complex clinical syndrome resulting from impairment of ventricular filling or ejection of blood.Management of patients with HF still remains a clinical challenge and many current therapies have uncertain impacts on long-term morbidity and mortality.Sodium-glucose co-transporter 2 inhibitors (SGLT2i) were initially developed for their glucose-lowering effect and subsequently have been shown to decrease the risk of Hospitalization for Heart Failure (HHF).After the initial Cardiovascular Outcome Trials (CVOTs)new datahaveprovided the evidence of benefits ofthese agents in reducing cardiovascular mortality and HHFin patients with Heart Failure with reduced ejection fraction (HFrEF) with or without co-existing Type 2 Diabetes (T2DM).In this narrative review, we have summarized the current therapies in the management of heart failure and clinical evidences with SGLT2i with special focus onDapagliflozin for clinical outcomes in HFrEF patients. We have also reviewed the latest guidelines that have proposed the use of SGLT2i in the management of HFrEF.