Inhibitors of sodium-glucose transport protein 2: A new multidirectional therapeutic option for heart failure patients
Jacek Kubica, Aldona Kubica, Klaudyna Grzelakowska, Wioleta Stolarek, Zofia Grąbczewska, Piotr Michalski, Piotr Niezgoda, Stanisław Bartuś, Andrzej Budaj, Mariusz Dąbrowski, Jarosław Dróżdż, Ryszard Gellert, Miłosz Jaguszewski, Piotr Jankowski, Jacek Legutko, Maciej Lesiak, Przemysław Leszek, Jolanta Małyszko, Przemysław Mitkowski, Jadwiga Nessler, Krzysztof Pawlaczyk, Jolanta M. Siller‐Matula, Tomasz Stompór, Bogumił Wolnik, Eliano Pio Navarese
Abstract
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.