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胰高血糖素样肽-1受体激动剂与心肌病关联的研究进展

Research Progress on the Association Between GLP-1 Receptor Agonists and Cardiomyopathy.

作者信息

Yang Xiao, Li Xinghui

机构信息

The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, 730000 Lanzhou, Gansu, China.

Department of Cardiology, Gansu Provincial People's Hospital, 730000 Lanzhou, Gansu, China.

出版信息

Rev Cardiovasc Med. 2025 Aug 30;26(8):37180. doi: 10.31083/RCM37180. eCollection 2025 Aug.

DOI:10.31083/RCM37180
PMID:40927090
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12415761/
Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a promising new class of drugs, whose clinical potential has recently been explored. Various preclinical studies and clinical trials initially demonstrated the efficacy of GLP-1RAs in treating type 2 diabetes mellitus (T2DM). However, long-term clinical practice has revealed that GLP-1RAs also exhibit significant efficacy and preventive effects in cardiovascular diseases. These effects are mediated through multiple gene pathways; thus, these drugs have shown substantial potential for further development in different clinical contexts. Cardiomyopathy, which constitutes a significant proportion of cardiovascular-related diseases, is increasingly prevalent, with its incidence rising annually. Thus, following the recent surge in research on cardiomyopathy, this review aims to summarize the latest findings regarding the association between GLP-1RAs and cardiomyopathy. This review begins with an introduction to GLP-1RAs, discussing their specific mechanisms of action. This article then addresses the pathogenesis, progression, and mechanisms of cardiomyopathy. Subsequently, a detailed analysis of the relationship between GLP-1RAs and cardiomyopathy is conducted. Finally, this review summarizes and discusses the latest literature on the impact of GLP-1RAs on the risk of various types of cardiomyopathy, as well as the potential underlying biological mechanisms, to provide clinical guidance on the use of GLP-1RAs in the treatment of cardiomyopathy.

摘要

胰高血糖素样肽-1受体激动剂(GLP-1RAs)是一类前景广阔的新型药物,其临床潜力最近已得到探索。各种临床前研究和临床试验最初证明了GLP-1RAs在治疗2型糖尿病(T2DM)方面的疗效。然而,长期临床实践表明,GLP-1RAs在心血管疾病中也表现出显著的疗效和预防作用。这些作用是通过多种基因途径介导的;因此,这些药物在不同临床环境中显示出巨大的进一步开发潜力。心肌病在心血管相关疾病中占很大比例,且日益普遍,其发病率逐年上升。因此,随着最近心肌病研究的激增,本综述旨在总结关于GLP-1RAs与心肌病之间关联的最新发现。本综述首先介绍GLP-1RAs,讨论其具体作用机制。本文接着阐述心肌病的发病机制、进展过程和机制。随后,对GLP-1RAs与心肌病之间的关系进行详细分析。最后,本综述总结并讨论了关于GLP-1RAs对各类心肌病风险影响的最新文献,以及潜在的生物学机制,为GLP-1RAs在心肌病治疗中的应用提供临床指导。

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本文引用的文献

1
Disparities in heart failure deaths among people with diabetes in the United States: 1999-2020.1999 - 2020年美国糖尿病患者心力衰竭死亡情况的差异
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Prevalence, Patient Characteristics, and Treatment of Patients with Hypertrophic Cardiomyopathy: A Nationwide Payer Database Study.肥厚型心肌病患者的患病率、患者特征及治疗:一项全国性医保数据库研究
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Long-term prognostic impact of glucagon-like peptide-1 receptor agonist before ST-segment elevation myocardial infarction in patients with type 2 diabetes: a nationwide cohort study.
2型糖尿病患者在ST段抬高型心肌梗死前使用胰高血糖素样肽-1受体激动剂的长期预后影响:一项全国性队列研究。
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Front Endocrinol (Lausanne). 2024 Dec 5;15:1502050. doi: 10.3389/fendo.2024.1502050. eCollection 2024.
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Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure: SUMMIT CMR Substudy.替尔泊肽可减轻肥胖相关心力衰竭患者的左心室质量和心周脂肪组织:SUMMIT CMR 子研究
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GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type 2 Diabetes: Pleiotropic Cardiometabolic Effects and Add-on Value of a Combined Therapy.GLP-1 受体激动剂和 SGLT2 抑制剂在 2 型糖尿病中的应用:多效性心血管代谢效应及联合治疗的附加价值。
Drugs. 2024 Nov;84(11):1347-1364. doi: 10.1007/s40265-024-02090-9. Epub 2024 Sep 28.
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Glucagon-like peptide-1 receptor: mechanisms and advances in therapy.胰高血糖素样肽-1 受体:作用机制与治疗进展。
Signal Transduct Target Ther. 2024 Sep 18;9(1):234. doi: 10.1038/s41392-024-01931-z.
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Effect of Semaglutide on Cardiac Structure and Function in Patients With Obesity-Related Heart Failure.司美格鲁肽对肥胖相关性心力衰竭患者心脏结构和功能的影响。
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Microglia Involvement into Acute and Chronic Brain Damage in Diabetic Rats: Impact of GLP-1RA and SGLT-2i.糖尿病大鼠急性和慢性脑损伤中的小胶质细胞参与:GLP-1RA 和 SGLT-2i 的影响。
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