Duan Xiangling, Zhang Xiaomeng, Sun Bao
Department of Pharmacy, The Second Xiangya Hospital, Central South University, No. 139, People's Middle Street, Changsha, 410011, China.
National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Cardiovasc Diabetol. 2025 Apr 28;24(1):186. doi: 10.1186/s12933-025-02750-4.
As a heterogeneous syndrome, heart failure with preserved ejection fraction (HFpEF) has become the leading form of heart failure worldwide. Increasing evidence has identified that diabetes mellitus (DM) increases the risk of HFpEF. Worse still, the coexistence of both diseases poses a great threat to human health by further worsening the cardiovascular system and accelerating the progression of diabetes. Although several studies have indicated that the novel antidiabetic drugs, including sodium glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase 4 inhibitors (DPP4i) provide the cardiovascular benefits in T2DM patients with HFpEF, the elaborated roles and mechanisms are not fully understood. In this review, we summarize the state-of-the-art evidence regarding the epidemiology and pathophysiology of diabetic HFpEF, and the landscape of the novel antidiabetic drugs in the treatment of diabetic HFpEF, as well as discuss the relevant mechanisms, aiming to broaden the understanding of diabetic HFpEF and gain new insight into the treatment of this disease.
射血分数保留的心力衰竭（HFpEF）作为一种异质性综合征，已成为全球心力衰竭的主要形式。越来越多的证据表明，糖尿病（DM）会增加HFpEF的风险。更糟糕的是，这两种疾病并存会进一步恶化心血管系统并加速糖尿病进展，从而对人类健康构成巨大威胁。尽管多项研究表明，新型抗糖尿病药物，包括钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）、胰高血糖素样肽-1受体激动剂（GLP-1 RA）和二肽基肽酶4抑制剂（DPP4i），对合并HFpEF的2型糖尿病（T2DM）患者具有心血管益处，但其具体作用和机制尚未完全明确。在本综述中，我们总结了关于糖尿病性HFpEF的流行病学和病理生理学的最新证据，以及新型抗糖尿病药物在治疗糖尿病性HFpEF方面的情况，并探讨相关机制，旨在拓宽对糖尿病性HFpEF的认识，并为该疾病的治疗获得新的见解。
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