Emergency Medicine Department, Attikon University Hospital, Athens, Greece.
Department of Occupational Therapy, University of Western Macedonia, Ptolemaida, Greece.
Expert Rev Clin Pharmacol. 2023 Feb;16(2):149-160. doi: 10.1080/17512433.2023.2173574. Epub 2023 Feb 2.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a class of oral antiglycemic agents that have emerged as a new therapeutic strategy for heart failure (HF) with reduced ejection fraction (HFrEF) and, potentially, for HF with preserved ejection fraction (HFpEF).
Ongoing efforts to clarify the exact mechanisms of action of SGLT2 inhibitors (SGLT2i) reveal that glycosuria and osmotic diuresis, resulting from the blockade of renal receptors, is not the sole pathophysiological mechanism. Nevertheless, the underlying mechanisms, accounting for their cardiovascular beneficial effects which have been clearly demonstrated in clinical trials, remain unclear. The aim of this review is to summarize the primary outcomes of large-scale studies regarding the use of SGLT2i in HF and provide an overview of the potential pathways involved in the SGLT2i-mediated cardioprotection.
SGLT2i exhibit favorable pleiotropic effects, which extend beyond their primary indication as pharmaceutical agents intended for glycemic control. Given their unique pathophysiological profile, these agents have revolutionized the management of HF, while in the near future, it is possible that evolving research in the field may unfold further perspectives on their potential use in the treatment of other chronic conditions.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂是一类口服抗糖尿病药物，已成为射血分数降低的心力衰竭（HFrEF）和潜在射血分数保留的心力衰竭（HFpEF）的新治疗策略。
目前，人们正在努力阐明 SGLT2 抑制剂（SGLT2i）的确切作用机制，结果表明，肾脏受体阻断导致的糖尿和渗透性利尿并非唯一的病理生理机制。然而，其心血管有益作用的潜在机制，在临床试验中已得到明确证实，但仍不清楚。本综述的目的是总结 SGLT2i 在心力衰竭中的大规模研究的主要结果，并概述 SGLT2i 介导的心脏保护作用涉及的潜在途径。
SGLT2i 具有有利的多效性作用，超出了其作为用于血糖控制的药物的主要适应证。鉴于其独特的病理生理特征，这些药物彻底改变了心力衰竭的治疗方法，而在不久的将来，该领域不断发展的研究可能会为这些药物在治疗其他慢性疾病方面的潜在用途展开进一步的探讨。
