Inhibitors of sodium-glucose transport protein 2: A new multidirectional therapeutic option for heart failure patients

• Published in: Cardiology journal Vol. 30; no. 1; pp. 143 - 149
• Main Authors: Kubica, Jacek, Kubica, Aldona, Grzelakowska, Klaudyna, Stolarek, Wioleta, Grąbczewska, Zofia, Michalski, Piotr, Niezgoda, Piotr, Bartuś, Stanisław, Budaj, Andrzej, Dąbrowski, Mariusz, Drożdż, Jarosław, Gellert, Ryszard, Jaguszewski, Miłosz J, Jankowski, Piotr, Legutko, Jacek, Lesiak, Maciej, Leszek, Przemysław, Małyszko, Jolanta, Mitkowski, Przemysław, Nessler, Jadwiga, Pawlaczyk, Krzysztof, Siller-Matula, Jolanta, Stompór, Tomasz, Wolnik, Bogumił, Navarese, Eliano Pio
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 01-01-2023; Via Medica
• Subjects: Antidiabetics; Blood pressure; Cardiology; Cardiovascular disease; Clinical Cardiology; Diabetes Mellitus, Type 2 - drug therapy; Drug dosages; Fatty acids; Glucagon; Glucose; Glucose - therapeutic use; Glucosides - adverse effects; Heart failure; Heart Failure - drug therapy; Humans; Hyperglycemia; Hypertension; Hypoglycemic Agents - adverse effects; Insulin resistance; Internal medicine; Kidneys; Medical education; Medicine; Metabolism; Nephrology; Plasma; Proteins; Sodium; Sodium - metabolism; Sodium - therapeutic use; Sodium-Glucose Transporter 2 - metabolism; Sodium-Glucose Transporter 2 - therapeutic use; Sodium-Glucose Transporter 2 Inhibitors - pharmacology; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Uric acid; empagliflozin; heart failure; mechanisms; dapagliflozin; sodium-glucose co-transporters (SGLTs)
• ISSN: 1897-5593; 1898-018X
• DOI: 10.5603/CJ.a2021.0133

Several mechanisms have been suggested to explain positive cardiovascular effects observed in studies with sodium-glucose co-transporter 2 (SGLT2) inhibitors. The reduction in glucose reabsorption in proximal tubuli induced by SGLT2 inhibitors increases urinary glucose and sodium excretion resulting in increased osmotic diuresis and consequently in decreased plasma volume, followed by reduced preload. In addition, the hemodynamic effects of SGLT2 inhibition were observed in both hyper and euglycemic patients. Due to the complex and multidirectional effects induced by SGLT2 inhibitors, this originally antidiabetic group of drugs has been successfully used to treat patients with heart failure as well as for subjects with chronic kidney disease. Moreover, their therapeutic potential seems to be even broader than the indications studied to date.