Profili Nicia I, Castelli Roberto, Gidaro Antonio, Manetti Roberto, Maioli Margherita, Delitala Alessandro P
Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy.
Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy.
Pharmaceuticals (Basel). 2024 Oct 23;17(11):1419. doi: 10.3390/ph17111419.
Diabetes mellitus and heart failure are two diseases that are commonly found together, in particular in older patients. High blood glucose has a detrimental effect on the cardiovascular system, and worse glycemic control contributes to the onset and the recrudesce of heart failure. Therefore, any specific treatment aimed to reduce glycated hemoglobin may, in turn, have a beneficial effect on heart failure. Sodium-glucose cotransporter-2 inhibitors have been initially developed for the treatment of type 2 diabetes mellitus, and their significant action is to increase glycosuria, which in turn causes a reduction in glucose blood level and contributes to the reduction of cardiovascular risk. However, recent clinical trials have progressively demonstrated that the glycosuric effect of the sodium-glucose cotransporter-2 inhibitors also have a diuretic effect, which is a crucial target in the management of patients with heart failure. Additional studies also documented that sodium-glucose cotransporter-2 inhibitors improve the therapeutical management of heart failure, independently by the glycemic control and, therefore, by the presence of diabetes mellitus. In this review, we analyzed studies and trials demonstrating the efficacy of sodium-glucose cotransporter-2 inhibitors in treating chronic and acute heart failure.
糖尿病和心力衰竭是两种常见的并发疾病，尤其在老年患者中。高血糖对心血管系统有不利影响，而血糖控制不佳会导致心力衰竭的发作和复发。因此，任何旨在降低糖化血红蛋白的特定治疗方法，反过来可能对心力衰竭有有益影响。钠-葡萄糖协同转运蛋白2抑制剂最初是为治疗2型糖尿病而开发的，其显著作用是增加糖尿，进而导致血糖水平降低，并有助于降低心血管风险。然而，最近的临床试验逐渐证明，钠-葡萄糖协同转运蛋白2抑制剂的糖尿作用也具有利尿作用，这是心力衰竭患者管理中的一个关键靶点。其他研究还记录了钠-葡萄糖协同转运蛋白2抑制剂可改善心力衰竭的治疗管理，独立于血糖控制，因此也独立于糖尿病的存在。在本综述中，我们分析了证明钠-葡萄糖协同转运蛋白2抑制剂治疗慢性和急性心力衰竭疗效的研究和试验。
