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Cardioprotective Effects of Sodium-Glucose Cotransporter Subtype Inhibition on Ischemic and Pharmacological

Takashi Egashira1, Taiga Ichinomiya1, Akihiro Yokoyama1

  • 1Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN.

Cureus
|June 6, 2024
PubMed
Abstract

Insights

Clinical doses of SGLT2 inhibitors preserve ischemic preconditioning (IPC) cardioprotection despite SGLT1 inhibition. Olprinone also provides cardioprotective effects, even with strong SGLT1 inhibition.

Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Disease

Background:

  • Sodium-glucose cotransporter (SGLT) 2 inhibitors partially inhibit SGLT1.
  • The effect of clinical SGLT2 inhibitor doses on ischemic preconditioning (IPC) is unknown.
  • Cardioprotective effects under SGLT1 inhibition require examination.

Purpose of the Study:

  • Investigate if tofogliflozin abrogates IPC.
  • Examine if olprinone has cardioprotective effects under SGLT1 inhibition.

Main Methods:

  • Male Wistar rats underwent ischemia/reperfusion (I/R).
  • Treatments included saline, IPC, IPC with phlorizin, IPC with tofogliflozin (low and high dose), olprinone, and olprinone with phlorizin.
  • Infarct size and phosphorylated AMP-activated protein kinase (AMPK) expression were assessed.

Main Results:

  • IPC reduced infarct size, but this was lost with phlorizin (strong SGLT1 inhibition).
  • To fogliflozin (clinical dose) preserved IPC's infarct-reducing effect.
  • Olprinone reduced infarct size, an effect maintained even with phlorizin.

Conclusions:

  • Strong SGLT1 inhibition attenuates IPC's cardioprotective effect.
  • Clinical doses of SGLT2 inhibitors preserve IPC cardioprotection.
  • Olprinone offers cardioprotection independent of SGLT1 inhibition status.
Keywords:
cardioprotective effectischemia–reperfusion injuryischemic preconditioningsodium-glucose cotransportersodium-glucose cotransporter inhibitortype 2 diabetes

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