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Optical Mapping of Action Potentials and Calcium Transients in the Mouse Heart
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Published on: September 13, 2011

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Sodium-glucose Cotransporter 2 Inhibitors in Heart Failure: Potential Mechanisms of Action, Adverse Effects and

Juan Tamargo1

  • 1Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, CIBERCV Madrid, Spain.

European Cardiology
|May 28, 2019
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2Is) offer cardiorenal benefits for patients with type 2 diabetes and heart failure. This review explores their mechanisms, benefits, and adverse effects, highlighting future research questions.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Heart failure (HF) is a frequent complication in diabetic patients, leading to poorer prognoses.
  • Sodium-glucose cotransporter 2 inhibitors (SGLT2Is) improve glycemic control by increasing urinary glucose excretion.
  • Some SGLT2Is demonstrate cardiorenal benefits in type 2 diabetes (T2D) beyond glycemic control.

Purpose of the Study:

  • To analyze the mechanisms behind the cardiorenal benefits of SGLT2Is in T2D patients with HF.
  • To review the adverse effects associated with SGLT2Is in this patient population.
  • To identify future research directions regarding SGLT2I use in T2D and HF.

Main Methods:

  • Review of proposed mechanisms including hemodynamic, metabolic, hormonal, and direct cardiac/renal effects.
  • Analysis of clinical evidence for cardiovascular and renal benefits.
  • Evaluation of the safety profile and benefit/risk ratio of different SGLT2Is.

Main Results:

  • SGLT2Is reduce cardiovascular events and hospitalizations for heart failure.
  • These agents can slow the worsening of kidney function.
  • Proposed mechanisms involve multiple pathways, suggesting pleiotropic effects.

Conclusions:

  • SGLT2Is provide significant cardiorenal protection in T2D patients with heart failure.
  • Understanding the differential benefit/risk profiles is crucial for clinical application.
  • Further research is needed to fully elucidate mechanisms and optimize therapeutic strategies.
Keywords:
Type 2 diabetescardiovascular outcome trialsheart failuresafety profilesodium-glucose cotransporter inhibitorssodium–glucose cotransporter

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