Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China; Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.
Int Immunopharmacol. 2023 May;118:110072. doi: 10.1016/j.intimp.2023.110072. Epub 2023 Apr 3.
Ventricular remodeling is a pathological process of ventricular response to continuous stimuli such as pressure overload, ischemia or ischemia-reperfusion, which can lead to the change of cardiac structure and function structure, which is central to the pathophysiology of heart failure (HF) and is an established prognostic factor in patients with HF. Sodium glucose cotransporter 2 inhibitors (SGLT2i) get a new hypoglycemic drug that inhibit sodium glucose coconspirator on renal tubular epithelial cells. Recently, clinical trials increasingly and animal experiments increasingly have shown that SGLT2 inhibitors have been largely applied in the fields of cardiovascular diseases, forinstance heart failure, myocardial ischemia-reperfusion injury, myocardial infarction, atrial fibrillation, metabolic diseases such as obesity, diabetes cardiomyopathy and other diseases play a cardiovascular protective role in addition to hypoglycemic. These diseases are association with ventricular remodeling. Inhibiting ventricular remodeling can improve the readmission rate and mortality of patients with heart failure. So far, clinical trials and animal experiments demonstrate that the protective effect of SGLT2 inhibitors in the cardiovascular field is bound to inhibit ventricular remodeling. Therefore, this review briefly investigates the molecular mechanisms of SGLT2 inhibitors on ameliorating ventricular remodeling, and further explore the mechanisms of cardiovascular protection of SGLT2 inhibitors, in order to establish strategies for ventricular remodeling to prevent the progress of heart failure.
心室重构是心室对压力超负荷、缺血或缺血再灌注等持续刺激的病理性反应过程,可导致心脏结构和功能结构的改变,是心力衰竭(HF)病理生理学的核心,也是 HF 患者的既定预后因素。钠-葡萄糖共转运蛋白 2 抑制剂(SGLT2i)是一种新型的抑制肾脏近端小管上皮细胞钠-葡萄糖共转运蛋白的降糖药物。最近,临床试验和动物实验越来越多地表明,SGLT2 抑制剂已广泛应用于心血管疾病领域,例如心力衰竭、心肌缺血再灌注损伤、心肌梗死、心房颤动、肥胖、糖尿病心肌病等代谢性疾病,除了降血糖外,还具有心血管保护作用。这些疾病与心室重构有关。抑制心室重构可以改善心力衰竭患者的再入院率和死亡率。到目前为止,临床试验和动物实验表明,SGLT2 抑制剂在心血管领域的保护作用必然抑制心室重构。因此,本综述简要探讨了 SGLT2 抑制剂改善心室重构的分子机制,并进一步探讨了 SGLT2 抑制剂的心血管保护机制,以期为预防心力衰竭进展建立心室重构的防治策略。