Impact on Atrial Remodeling of Dapaglifozin in Patients With Heart Failure .

Inclusion Criteria: * Age \> 18 years * Prior diagnosis of HF, with at least one hospitalization for HF at any time. * NYHA class I-IV. * LVEF available (echocardiogram or cardiac MRI) within the last 12 months prior to enrolment. * Treatment according with contemporary guidelines recommendations and with stable doses of oral loop diuretics for at least 4 weeks * NT-proBNP \>600 pg/ml at screening (≥400 pg/ml if hospitalized for HF within the previous 12 months; ≥900 pg/ml If concomitant AF at * Screening irrespective of time to last HF hospitalization). Exclusion Criteria: * Dapagliflozin or other SGLT2i at any time in prior 6 months. * Type 1 diabetes mellitus (T1D) * Estimated glomerular filtration rate \< 30 ml/min/1.73 m2 as measured by the simplified Modification of Diet in Renal Disease (MDRD) formula at screening. * Symptomatic hypotension or systolic blood pressure (SBP) \<95 mmHg on 2 consecutive measurements at screening. * Uncontrolled hypertension, defined as SBP \>160 mmHg. * Current acute decompensated HF or hospitalization due to decompensated HF within 4 weeks prior to enrolment * The use of outpatient or inpatient i.v. diuretic therapy within 4 weeks prior to baseline. * Subjects who are currently receiving or have received inotropic agents within 12 weeks prior to baseline. * Myocardial infarction, unstable angina, stroke or transient ischemic attack within 12 weeks prior to enrolment * Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting or valvular repair/replacement within 12 weeks prior to enrolment or planned to undergo any of these operations after inclusion * Implantation of a cardiac resynchronization therapy (CRT) within 12 weeks prior to enrolment or intent to implant a CRT device * Previous cardiac transplantation or implantation of a ventricular assistance device (VAD) or similar device, or implantation expected after inclusion * HF due to restrictive cardiomyopathy, active myocarditis, constrictive pericarditis, hypertrophic (obstructive) cardiomyopathy or uncorrected primary valvular disease * Symptomatic bradycardia or second or third degree heart block without a pacemaker * History of allergic reactions or intolerance to dapagliflozin, or other iSGLT2, or any other compound * History of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within one year. * Hepatic impairment aspartate transaminase \[AST\] or alanine transaminase \[ALT\] \>3x the upper limit of normal \[ULN\]; or total bilirubin \>2x ULN at time of screening) * Women of child-bearing potential (ie, those who are not chemically or surgically sterilised or who are not post-menopausal) who are not willing to use a medically accepted method of contraception that is considered reliable in the judgment of the investigator or women who have a positive pregnancy test at enrollment or randomization or women who are breast-feeding * Participation in another clinical trial during the last month prior to enrolment * Inability of the patient, in the opinion of the investigator, to understand and/or comply with study medications, procedures and/or follow-up or any conditions that, in the opinion of the investigator, may render the patient unable to complete the study * Any concomitant disease limiting life expectancy in the following year (other than heart failure) * No possibility to give informed consent.