钠-葡萄糖协同转运蛋白2抑制剂使心力衰竭获益的作用机制

Mechanism of Benefit of Sodium-glucose Co-transporter 2 Inhibitors in Heart Failure

钠-葡萄糖协同转运蛋白2抑制剂是一类新型降糖药物,在心血管及肾脏保护方面展现出了巨大的优势。达格列净与心力衰竭不良结局的预防研究显示,无论是否合并糖尿病,钠-葡萄糖协同转运蛋白2抑制剂均可减少射血分数降低性心力衰竭患者的心血管死亡率、因心力衰竭再住院率和心力衰竭急诊率。但钠-葡萄糖协同转运蛋白2抑制剂使心力衰竭患者获益确切机制不明,现总结钠-葡萄糖协同转运蛋白2抑制剂对心力衰竭患者的影响以及探讨其可能的作用机制。

Sodium-glucose co-transporter 2(SGLT-2)inhibitors are a new class of antidiabetic drugs,which have shown great advantages in cardiovascular and renal protection.The Dapagliflozin and Heart Failure Prevention Outcome Study(DAPAHF)trial demonstrated the benefits of dapagliflozin to reduce cardiovascular mortality,rehospitalization and emergency for heart failure in patients with established heart failure with reduced ejection fraction.In DAPA-HF,the benefits of dapagliflozin on heart failure were seen to a similar extent in both patients with or without diabetes.However,the exact mechanism by which SGLT-2 inhibitors benefit patients with heart failure is unknown.This article summarizes the effects of SGLT-2 inhibitors on patients with heart failure and explores its possible mechanisms.