Brata Roxana, Pascalau Andrei Vasile, Fratila Ovidiu, Paul Ioana, Muresan Mihaela Mirela, Camarasan Andreea, Ilias Tiberia
Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 December 10, 410073 Oradea, Romania.
Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 December 10, 410073 Oradea, Romania.
Healthcare (Basel). 2024 Dec 6;12(23):2464. doi: 10.3390/healthcare12232464.
: The current review aims to present the beneficial effects of SGLT2 inhibitors (dapagliflozin and empagliflozin) on several hemodynamic parameters such as blood pressure, filtration pressure at the level of the glomerular capillaries, and the improvement of the preload and afterload of heart muscle. In order to stop chronic kidney disease (CKD) from progressing, SGLT2 inhibitors have become an important disease-modifying treatment. : Recent clinical studies have shown the success of these drugs in treating heart failure, reducing the risk of cardiovascular events, hospitalization, and mortality. : The hemodynamic effects of SGLT2 inhibitors include a diuretic effect, due to reduced sodium reabsorption. Also, at this level, numerous studies have confirmed the beneficial effect of dapagliflozin in patients with chronic kidney disease, associated with a 44% reduced risk of progression in this pathology. SGLT2 inhibitors are associated with a reduction in blood pressure and weight loss, because of their diuretic effect, especially empagliflozin, which can explain the beneficial effects in patients with heart failure. In addition, mainly empagliflozin reduces stiffness and arterial resistance. : Although the exact mechanism of action is unknown, SGLT2 inhibitors reduce the interstitial volume by blocking the tubular reabsorption of glucose. This leads to reduced blood pressure and enhanced endothelial function. Consequently, there have been improvements in hospitalization and fatality rates. Because of their beneficial effects, these medications have been guidelines for managing heart failure and chronic kidney disease.
本综述旨在阐述钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂（达格列净和恩格列净）对多种血流动力学参数的有益作用，如血压、肾小球毛细血管水平的滤过压，以及对心肌前负荷和后负荷的改善。为阻止慢性肾脏病（CKD）进展，SGLT2抑制剂已成为一种重要的疾病改善治疗方法。近期临床研究表明这些药物在治疗心力衰竭、降低心血管事件风险、住院率和死亡率方面取得了成功。SGLT2抑制剂的血流动力学效应包括利尿作用，这是由于钠重吸收减少所致。在此方面，众多研究证实了达格列净对慢性肾脏病患者的有益作用，该疾病进展风险降低了44%。SGLT2抑制剂与血压降低和体重减轻有关，因其利尿作用，尤其是恩格列净，这可以解释其对心力衰竭患者的有益作用。此外，主要是恩格列净降低了血管僵硬度和动脉阻力。尽管确切作用机制尚不清楚，但SGLT2抑制剂通过阻断肾小管对葡萄糖的重吸收来减少间质容积。这导致血压降低和内皮功能增强。因此，住院率和死亡率得到了改善。由于其有益作用，这些药物已成为管理心力衰竭和慢性肾脏病的指南。
