Gliflozins on HF in Regurgitant Rheumatic Heart

Inclusion Criteria: * All male or female patients having rheumatic heart disease with either mitral, aortic, tricuspid regurge as a single or combined valvular lesion * Patients aged 18 years or older at time of inclusion in the study * Patients with HF currently in NYHA class II-IV, or asymptomatic patients with proved mitral regurgitant lesion. * Body Mass Index (BMI) \< 45 kg/m2 Exclusion Criteria: * Advanced stage liver and kidney failure (glomerular filtration rate \< 20 mL/min/1.73 m2). * Patient with implanted cardiac pacemaker, implantable cardioverter-defibrillator (ICD) or cardiac re-synchronization therapy (CRT) or implanted left ventricular assist device (LVAD) * Diagnosis of cardiomyopathy induced by other etiologies rather than rheumatic heart disease eg, ischemia , dilated cardiomyopathy,…..etc within the 12 months prior to Visit 1 * Known allergy or hypersensitivity to SGLT-2 inhibitors * Women who are pregnant, nursing, or who plan to become pregnant while in the trial * ongoing hematological diseases and malignancies