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SGLT2 inhibitors and mechanisms of cardiovascular benefit: A state-of-the-art review
Verma, Subodh McMurray, John
Verma, Subodh
McMurray, John
Author
Abstract
Sodium–glucose cotransporter (SGLT)2 inhibitors have been demonstrated to reduce cardiovascular events, particularly heart failure, in cardiovascular outcome trials. Here, we review the proposed mechanistic underpinnings of this benefit. Specifically, we focus on the role of SGLT2 inhibitors in optimising ventricular loading conditions through their effect on diuresis and natriuresis, in addition to reducing afterload and improving vascular structure and function. Further insights into the role of SGLT2 inhibition in myocardial metabolism and substrate utilisation are outlined. Finally, we discuss two emerging themes: how SGLT2 inhibitors may regulate Na+/H+ exchange at the level of the heart and kidney and how they may modulate adipokine production. The mechanistic discussion is placed in the context of completed and ongoing trials of SGLT2 inhibitors in the prevention and treatment of heart failure in individuals with and without diabetes.
Keywords
Cardiovascular effects, Heart failure, Mechanisms, Review, SGLT2 inhibitors
Date
2018
Type
Journal article
Journal
Diabetologia
Book
Volume
61
Issue
10
Page Range
2108-2117
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled