Sodium-glucose co-transporter 2 inhibitor therapy: mechanisms of action in heart failure

Joshi, Shruti; Singh, Trisha; Newby, David E.; Singh, Jagdeep

doi:10.1136/heartjnl-2020-318060

Cited by 122 publications

(93 citation statements)

References 59 publications

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“…Furthermore, Joshi, SS. et al suggested improved glycaemic control, diuresis, weight reduction and a reduction in blood pressure, improved cardiomyocyte calcium handling, enhanced myocardial energetics, induced autophagy, and reduced epicardial fat as the proposed mechanisms of SGLT2i action in cardiovascular health and disease [ 35 ].…”

Section: Cardiovascular Protective Effects Of Sglt2imentioning

confidence: 99%

Multi-Organ Protective Effects of Sodium Glucose Cotransporter 2 Inhibitors

Yanai

Hakoshima

Adachi

et al. 2021

IJMS

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Sodium glucose cotransporter 2 inhibitors (SGLT2i) block the reabsorption of glucose by inhibiting SGLT2, thus improving glucose control by promoting the renal excretion of glucose, without requiring insulin secretion. This pharmacological property of SGLT2i reduces body weight and improves insulin resistance in diabetic patients. Such beneficial metabolic changes caused by SGLT2i are expected to be useful not only for glucose metabolism, but also for the protection for various organs. Recent randomized controlled trials (RCTs) on cardiovascular diseases (EMPA-REG OUTCOME trial and CANVAS program) showed that SGLT2i prevented cardiovascular death and the development of heart failure. RCTs on renal events (EMPA-REG OUTCOME trial, CANVAS program, and CREDENCE trial) showed that SGLT2i suppressed the progression of kidney disease. Furthermore, SGLT2i effectively lowered the liver fat content, and our study demonstrated that SGLT2i reduced the degree of hepatic fibrosis in patients at high-risk of hepatic fibrosis. Such promising properties of SGLT2i for cardiovascular, renal, and hepatic protection provide us the chance to think about the underlying mechanisms for SGLT2i-induced improvement of multiple organs. SGLT2i have various mechanisms for organ protection beyond glucose-lowering effects, such as an increase in fatty acids utilization for hepatic protection, osmotic diuresis for cardiac protection, an improvement of insulin resistance for anti-atherogenesis, and an improvement of tubuloglomerular feedback for renal protection.

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Section: Cardiovascular Protective Effects Of Sglt2imentioning

confidence: 99%

Multi-Organ Protective Effects of Sodium Glucose Cotransporter 2 Inhibitors

Yanai

Hakoshima

Adachi

et al. 2021

IJMS

View full text Add to dashboard Cite

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“…Proposed explanations for the beneficial effects of SGLT2i are: improved cardiac energy metabolism, anti-inflammatory and anti-oxidant effects, reduced arterial stiffness, reduced blood pressure, renal protection, increased hematocrit, positive cardiac remodeling, antiapoptotic and antifibrotic effects. Irrespective of the explanation provided, the benefits on HF appear to have a rapid onset, to be glucose-independent and to be associated with improved renal function [13][14][15].…”

Section: Sodium-glucose Co-transporters 2 Inhibitorsmentioning

confidence: 99%

Combining New Classes of Drugs for HFrEF: from Trials to Clinical Practice

Sinagra

Pagura

Stolfo

et al. 2021

European Journal of Internal Medicine

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Pharmacological approach to heart failure with reduced ejection fraction (HFrEF) is evolving, as recently published large randomized clinical trials have implemented the disposal of HFrEF treatments with four new classes of drugs, namely angiotensin receptor/neprilysin inhibitor , sodium-glucose co-transporters 2 inhibitors , soluble guanylate cyclase modulators and myosin activators, which have proved to further improve patients' quality of life and long-term outcomes. As these novel drugs target additional pathways not already intercepted by the guideline-directed medical therapy, integration of them in the management of HFrEF is desirable. This review paper aims to provide an overview of the current evolving concepts of HFrEF therapy joining the most recent evidences and to furnish practical suggestions for the use of these new classes of drugs in clinical practice

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“…Thiazolidinediones) in treating heart failure, and therefore, there was a dire need for an effective and safe therapeutic option for diabetic patients with heart failure. 2 SGLT-2 inhibitor is one of the novel therapeutic strategy used to treat T2DM. To maintain glucose homeostasis in human body, Kidneys regulate gluconeogenesis, glucose uptake from circulation, and glucose reabsorption from urine filtered in the renal glomeruli.…”

Section: Introductionmentioning

confidence: 99%