Underlying mechanisms and cardioprotective effects of SGLT2i and GLP-1Ra: insights from cardiovascular magnetic resonance

• Published in: Cardiovascular diabetology Vol. 23; no. 1; p. 94
• Main Authors: Cersosimo, Angelica, Salerno, Nadia, Sabatino, Jolanda, Scatteia, Alessandra, Bisaccia, Giandomenico, De Rosa, Salvatore, Dellegrottaglie, Santo, Bucciarelli-Ducci, Chiara, Torella, Daniele, Leo, Isabella
• Format: Journal Article
• Language: English
• Published: England BioMed Central 11-03-2024; BMC
• Subjects: Blood pressure; Cardiomyocytes; Cardiomyopathy; Cardiovascular diseases; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - prevention & control; Cardiovascular magnetic resonance; Cardiovascular System; Clinical outcomes; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2; Diabetic cardiomyopathy; Ejection fraction; GLP-1Ra; Glucagon; Glucagon-like peptide 1; Glucagon-Like Peptide-1 Receptor; Heart failure; Homeostasis; Hospitalization; Humans; Hypoglycemic Agents - therapeutic use; Ischemia; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Morbidity; Mortality; Nitric oxide; Phosphorylation; Review; SGLT2i; Sodium-glucose cotransporter; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Diabetic cardiomyopathy; GLP-1Ra; Cardiovascular magnetic resonance; SGLT2i
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02181-7

Originally designed as anti-hyperglycemic drugs, Glucagon-Like Peptide-1 receptor agonists (GLP-1Ra) and Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated protective cardiovascular effects, with significant impact on cardiovascular morbidity and mortality. Despite several mechanisms have been proposed, the exact pathophysiology behind these effects is not yet fully understood. Cardiovascular imaging is key for the evaluation of diabetic patients, with an established role from the identification of early subclinical changes to long-term follow up and prognostic assessment. Among the different imaging modalities, CMR may have a key-role being the gold standard for volumes and function assessment and having the unique ability to provide tissue characterization. Novel techniques are also implementing the possibility to evaluate cardiac metabolism through CMR and thereby further increasing the potential role of the modality in this context. Aim of this paper is to provide a comprehensive review of changes in CMR parameters and novel CMR techniques applied in both pre-clinical and clinical studies evaluating the effects of SGLT2i and GLP-1Ra, and their potential role in better understanding the underlying CV mechanisms of these drugs.