Sodium-Glucose Cotransporter 2 Inhibitors and Cardiac Remodeling

Husam M. Salah, Subodh Verma, Carlos G. Santos-Gallego, Ankeet S. Bhatt, Muthiah Vaduganathan, Muhammad Shahzeb Khan, Renato D. Lopes, Subhi J. Al’Aref, Darren K. McGuire, Marat Fudim

Research output: Contribution to journalReview articlepeer-review

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have evident cardiovascular benefits in patients with type 2 diabetes with or at high risk for atherosclerotic cardiovascular disease, heart failure with reduced ejection fraction, heart failure with preserved ejection fraction (only empagliflozin and dapagliflozin have been investigated in this group so far), and chronic kidney disease. Prevention and reversal of adverse cardiac remodeling is one of the mechanisms by which SGLT2 inhibitors may exert cardiovascular benefits, especially heart failure-related outcomes. Cardiac remodeling encompasses molecular, cellular, and interstitial changes that result in favorable changes in the mass, geometry, size, and function of the heart. The pathophysiological mechanisms of adverse cardiac remodeling are related to increased apoptosis and necrosis, decreased autophagy, impairments of myocardial oxygen supply and demand, and altered energy metabolism. Herein, the accumulating evidence from animal and human studies is reviewed investigating the effects of SGLT2 inhibitors on these mechanisms of cardiac remodeling.

Original languageEnglish (US)
JournalJournal of cardiovascular translational research
DOIs
StateAccepted/In press - 2022

Keywords

  • Cardiac remodeling
  • Heart failure
  • HFpEF
  • HFrEF
  • Mechanisms
  • SGLT2 inhibitors
  • SGLT2i

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmaceutical Science
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)

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