Cardiovascular Institute, Warren Alpert Medical School at Brown University, Providence, RI, USA.
Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA.
Ann Med. 2020 Aug;52(5):178-190. doi: 10.1080/07853890.2020.1767298. Epub 2020 May 22.
Heart failure (HF) is a major cause of morbidity and mortality worldwide, and the burden of HF continues to rise. There has been an interest in sodium-glucose co-transporter-2 (SGLT2) inhibitors for their role in reducing HF hospitalizations in pivotal trials. Since these agents were approved by the Food and Drug Administration for the management of diabetes mellitus, multiple small trials and analyses have tried to explain the underlying beneficial mechanisms in HF . In this review, we discuss different mechanisms by which SGLT2 inhibitors play hemodynamic, metabolic, and cellular roles in different HF phenotypes. We also address issues pertaining to the safety of these relatively newer agents.KEY MESSAGESSGLT2 inhibitors are associated with a reduction in HF hospitalizations in both diabetics and non-diabetics.The beneficial role of SGLT2 inhibitors in reducing HF hospitalization is observed among participants with established cardiovascular disease/HF and at-risk population.SGLT2 inhibitors pose an important role in renal protection, another mechanism by which these medications can be helpful in HF patients.
心力衰竭（HF）是全球发病率和死亡率的主要原因，HF 的负担继续增加。人们对钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂很感兴趣，因为它们在关键试验中具有降低 HF 住院率的作用。自从这些药物被美国食品和药物管理局批准用于治疗糖尿病以来，许多小型试验和分析试图解释 HF 中潜在的有益机制。在这篇综述中，我们讨论了 SGLT2 抑制剂在不同 HF 表型中通过血流动力学、代谢和细胞作用发挥作用的不同机制。我们还讨论了这些相对较新的药物的安全性问题。
关键信息
SGLT2 抑制剂可降低糖尿病和非糖尿病患者的 HF 住院率。
SGLT2 抑制剂在降低 HF 住院率方面的有益作用在已患有心血管疾病/HF 和高危人群中观察到。
SGLT2 抑制剂在肾脏保护方面发挥着重要作用，这也是这些药物对 HF 患者有帮助的另一种机制。
