Varadhan Ajay, Stephan Katarina, Gupta Rahul, Vyas Apurva V, Ranchal Purva, Aronow Wilbert S, Hawwa Nael, Lanier Gregg M
Department of Basic Sciences, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA.
Department of Biomedical Engineering, Columbia University, New York, NY, USA.
Expert Rev Clin Pharmacol. 2022 Feb;15(2):147-159. doi: 10.1080/17512433.2022.2051480. Epub 2022 Mar 21.
: There is an unmet need for therapies that improve overall mortality and morbidity for patients with preserved ejection fraction, who comprise roughly half of all heart failure (HF) cases. The growing role of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in cardiovascular outcomes provides a paradigm shift in the treatment of HF.
: This review article provides a general overview of the growing role of SGLT2is and summarizes the mechanism of action, side effects, and contraindications for the treatment of HF. We also discuss recent clinical trials measuring the effects of different SGLT2is as possible treatment options for HF with reduced ejection fraction and HF with mid-range and preserved EF. We conducted a review of all the randomized, controlled studies with SGLT2is in patients with known heart failure with and without type-2 diabetes (T2DM). We performed a literature search in PubMed, Google Scholar, the Web of Science, and the Cochrane Library while screening results by the use of titles and abstracts.
: The promising pathophysiological profile of SGLT2i and their role in cardioprotective effects demonstrate an invaluable discovery in the management of patients with HF irrespective of their diabetes status.
对于射血分数保留的患者，改善其总体死亡率和发病率的治疗方法仍存在未满足的需求，这类患者约占所有心力衰竭（HF）病例的一半。钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）在心血管结局方面日益重要的作用为心力衰竭治疗带来了范式转变。
本文综述了SGLT2i日益重要的作用，并总结了其治疗HF的作用机制、副作用和禁忌证。我们还讨论了近期测量不同SGLT2i对射血分数降低的HF以及射血分数中等范围和保留的HF的治疗效果的临床试验。我们对所有使用SGLT2i治疗已知心力衰竭且伴有或不伴有2型糖尿病（T2DM）患者的随机对照研究进行了综述。我们在PubMed、谷歌学术、科学网和考克兰图书馆进行了文献检索，同时通过标题和摘要筛选结果。
SGLT2i有前景的病理生理特征及其在心脏保护作用中的作用表明，无论糖尿病状态如何，在HF患者管理中这是一项宝贵的发现。
