Clinical Research Directory

Inclusion Criteria: \- 1. Adults with ASD and significant left to right shunt which is anatomically suitable for transcatheter device closure. 2\. Adults (age ≥18 years) of both genders. 3. Sinus rhythm on presentation. Exclusion Criteria: * 1\. Presence of other congenital anomalies e.g. AV canal, CoA, VSDs, PDA, dextrocardia. 2\. Significant irreversible pulmonary hypertension (PVR ≥ 5 wood units) or Eisenmenger syndrome. 3\. Patients presented with arrythmias (especially atrial fibrillation). 4. Severe left ventricular systolic dysfunction (LV ejection fraction (\< 50%). 5. Significant Valvular Heart Disease. 6. Patients known to have history of ischemic heart disease or percutaneous coronary interventions. 7\. Severely impaired renal function defined as an estimated glomerular filtration rate (eGFR) (\< 30 mL/min/1.73m²) 8. Patients with contraindications for SGLT2i: Type 1 diabetes mellitus, history of diabetic ketoacidosis, recurrent severe urinary tract infections, active genital mycotic infections, or known hypersensitivity to dapagliflozin. 9\. Poor-quality Echocardiography images precluding strain analysis