Moka Murali Krishna, K Sriram D, George Melvin
Department of Clinical Research, Hindu Mission Hospital, Tambaram, Chennai, 600045, Tamil Nadu, India.
Department of Diabetology and Endocrinology, Hindu Mission Hospital, Tambaram, Chennai, 600045, Tamil Nadu, India.
Acta Diabetol. 2025 Jan;62(1):1-10. doi: 10.1007/s00592-024-02363-5. Epub 2024 Sep 10.
We aim to explore the potential of diverse treatments, including perhexiline, calcium channel blockers, anti-hypertensives, PDE5 inhibitors, anti-anginal drugs, aldose reductase inhibitors, and SGLT-2 inhibitors, supported by clinical evidence. Additionally, this review seeks to identify novel therapeutic targets and future avenues for improving cardiovascular outcomes in diabetic populations.
We performed a comprehensive literature review of English-language studies across multiple electronic databases, such as PubMed, ScienceDirect, Scopus, and Google Scholar, focusing on clinical trials. The search utilized keywords including 'Anti-hyperglycaemic drug,' 'Diabetic cardiomyopathy,' 'DPP-4 inhibitors,' 'GLP-1 receptor agonists,' 'Heart failure,' and 'SGLT-2 inhibitors.'
We assessed clinical investigations in the treatment of cardiomyopathy and diabetes mellitus (DM) that are enhancing our understanding through trials evaluating the Polypill, Perhexiline, Eplerenone, IMB-1018972, AT-001, tadalafil, and dapagliflozin inhibitors. The development of new targeted interventions is of paramount importance due to the overlooked early symptoms, the complexity of the cellular and molecular pathways involved, and the absence of effective drug therapies.
Pharmacological treatments like GLP-1 agonists, SGLT-2 inhibitors, NHE-1, NHE-3, and PPAR-γ agonists show promise for treating DCM. These treatments improve myocardial glucose absorption, address dysregulated glucose and lipid metabolism, and lower heart failure and cardiovascular events. Further research is needed to confirm effectiveness and safety.
我们旨在探讨多种治疗方法的潜力，包括哌克昔林、钙通道阻滞剂、抗高血压药、磷酸二酯酶5抑制剂、抗心绞痛药物、醛糖还原酶抑制剂和钠-葡萄糖协同转运蛋白2抑制剂，并提供临床证据支持。此外，本综述旨在确定改善糖尿病患者心血管结局的新治疗靶点和未来途径。
我们对多个电子数据库（如PubMed、ScienceDirect、Scopus和谷歌学术）中的英文研究进行了全面的文献综述，重点关注临床试验。搜索使用的关键词包括“抗高血糖药物”、“糖尿病性心肌病”、“二肽基肽酶4抑制剂”、“胰高血糖素样肽1受体激动剂”、“心力衰竭”和“钠-葡萄糖协同转运蛋白2抑制剂”。
我们评估了在心肌病和糖尿病治疗方面的临床研究，这些研究通过评估多效药丸、哌克昔林、依普利酮、IMB-1018972、AT-001、他达拉非和达格列净抑制剂的试验，加深了我们的理解。由于早期症状被忽视、所涉及的细胞和分子途径复杂以及缺乏有效的药物治疗，开发新的靶向干预措施至关重要。
胰高血糖素样肽1激动剂、钠-葡萄糖协同转运蛋白2抑制剂、钠氢交换体1、钠氢交换体3和过氧化物酶体增殖物激活受体γ激动剂等药物治疗方法在治疗糖尿病性心肌病方面显示出前景。这些治疗方法可改善心肌葡萄糖摄取，解决葡萄糖和脂质代谢失调问题，并降低心力衰竭和心血管事件的发生率。需要进一步研究以确认其有效性和安全性。
