[Cardioprotective effects of glucagon-like peptide-1: preclinical and clinical data]

The glucagon-like peptide-1 (GLP-1) is a 30 amino acid incretin hormone synthesized by L cells of ileum and colon in response to a meal. Once secreted, it is rapidly inactivated by specific enzymes called dipeptidyl dipeptidase 4. The main actions of GLP-1 are (i) to stimulate insulin secretion; (ii) to inhibit glucagon secretion; (iii) to elicit a delay of gastric emptying time; and (iv) to stimulate neogenesis of insulin-secreting cells. Patients with type 2 diabetes show low GLP-1 concentrations in response to a meal, making treatment with incretin mimetics specifically indicated in this patient subset. Besides these effects on intermediary metabolism, GLP-1 also plays an important role in the cardiovascular system by reducing blood pressure, improving endothelial function, and increasing myocardial contractility. These mechanisms of action will be discussed in detail in this article.