Beyond Glycemic Control: Mechanistic Insights Into SGLT-2 Inhibitors in Heart Failure Management

Author:

Garg Shreya1,Kanagala Sai Gautham2,Anamika Fnu3,Parikh Kinna4,Kaur Harmanjit5,Garg Nikita6,Jain Rohit7

Affiliation:

1. Department of Internal Medicine, Dayanand Medical College & Hospital, Punjab, India

2. Department of Internal Medicine, Metropolitan Hospital Center, New York, NY

3. Department of Internal Medicine, University College of Medical Sciences, Delhi, India

4. Department of Internal Medicine, GMERS Medical College, Gujarat, India

5. Department of Internal Medicine, Government Medical College, Punjab, India

6. Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL

7. Department of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.

Abstract

Heart failure is a common and clinically significant cardiac condition that causes significant morbidity and mortality in the United States. Diabetes and hypertension are 2 of the most common comorbidities associated with heart failure. Other risk factors for heart failure include smoking, obesity, and intrinsic cardiac diseases such as myocardial infarction and valvular pathologies. All of these conditions, to some extent, cause remodeling within the cardiomyocyte, which eventually leads to the development of congestive heart failure. Over the years, using diuretics and medications that inhibit the Renin-Angiotensin-Aldosterone System has been the traditional treatment for congestive heart failure. But in recent years studies in the diabetic population revealed that sodium-glucose cotransporter-2 inhibitors had a negative impact on the remodeling of cardiomyocytes. In this review, we discuss the numerous molecular mechanisms by which these recently developed medicines inhibit remodeling in cardiomyocytes, independent of their intended effect of decreasing blood glucose levels. Furthermore, it emphasizes the use of these drugs in diabetic as well as non-diabetic patients as a promising adjunct to ongoing heart failure treatment.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine,General Medicine

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