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RATIONALE Dapagliflozin improves the prognosis of patients with heart failure (HF), regardless left ventricular ejection fraction (LVEF). However, its effect on cardiac remodeling parameters, specifically left atrial (LA) remodeling, is not well established. METHODS DAPA-MODA trial (NCT04707352) is a multicenter, single-arm, open-label, prospective and interventional study that aimed to evaluate the effect of dapagliflozin on cardiac remodeling parameters over six months.. Patients with stable chronic heart failure receiving optimized guideline-directed therapy, except for any SGLT2i, were included. Echocardiography was performed at baseline, 30 and 180 days, and analyzed by a central core-lab in a blinded manner to both patient and time. The primary end-point was the change of maximal LA volume index (LAVI). RESULTS A total of 162 patients (64.2% men, 70.5±10.6 years, 52% LVEF>40%) were included in the study. At baseline, LA dilatation was observed (LAVI 49.1±24.4 ml/m2) and LA parameters were similar between LVEF-based phenotypes (≤40% vs. >40%). LAVI showed a significant reduction at 180 days (-6.6% (CI95% -11.1, -1.8, p=0.008), primarily due to a decrease in reservoir volume (-13.8%, p=0.007). LV geometry improved with significant reductions in LV mass index (-13.9%, p<0.001), end-diastolic volume (-8.0%, p<0.001) and end-systolic volume (-11.9%, p<0.001) at 180 days. NT-proBNP showed a significant reduction at 180 days (-18.2% [CI95% -27.1, -8.2], p<0.001), without changes in filling doppler measures. CONCLUSION Dapagliflozin administration in stable out-setting patients with chronic HF and optimized therapy results in global reverse remodeling of cardiac structure, including reductions in LA volumes and improvement in LV geometry and NT-proBNP concentrations. This article is protected by copyright. All rights reserved.