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Mechanisms and Therapeutic Potential of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure

Zuyuan Huang1, Guoxing Ling1, Chen Fang1

  • 1Department of Cardiovascular Surgery, The First Affiliated Hospital of Guangxi Medical University, 530021 Nanning, Guangxi, China.

Reviews in Cardiovascular Medicine
|May 11, 2026
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) show significant efficacy in managing heart failure (HF). This review explores their mechanisms, clinical outcomes, and future potential in treating various HF types.

Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Heart failure (HF) is a leading cause of hospitalization and mortality worldwide.
  • Current HF treatments have limitations, highlighting the need for novel therapeutic strategies.

Purpose of the Study:

  • To review the mechanisms of action of SGLT2 inhibitors (SGLT2is) in heart failure.
  • To evaluate the clinical efficacy and safety of SGLT2is across different HF phenotypes.
  • To discuss future research and clinical applications of SGLT2is for HF management.

Main Methods:

  • Comprehensive literature review of SGLT2is in heart failure.
  • Analysis of preclinical and clinical studies focusing on SGLT2is' effects.
  • Evaluation of trial outcomes in HF with reduced, preserved, and mid-range ejection fraction.

Main Results:

  • SGLT2is demonstrate multifaceted benefits in HF, impacting hemodynamics, cardiac metabolism, inflammation, oxidative stress, and neuroendocrine pathways.
  • Clinical trials confirm the efficacy of SGLT2is in improving outcomes for patients with HFrEF, HFpEF, and HFmrEF.
  • SGLT2is exhibit a favorable safety profile in the context of HF treatment.

Conclusions:

  • SGLT2 inhibitors represent a significant therapeutic advancement for heart failure management.
  • Further research should explore personalized treatment strategies and long-term outcomes.
  • SGLT2is are poised to become a cornerstone therapy for a broad spectrum of HF patients.

Keywords:
clinical therapyheart failuremechanisms of actionsodium–glucose cotransporter 2 inhibitors

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