SGLT2抑制剂治疗心力衰竭的机制

Mechanisms of SGLT2 inhibitors therapyy for the heart failure

钠-葡萄糖协同转运蛋白2(sodium-glucose cotransport protein 2,SGLT2)抑制剂是一种新型口服降糖药。临床研究证实,无论是否患有2型糖尿病,SGLT2抑制剂都可以改善心力衰竭患者的预后,但其机制尚不明确。SGLT2抑制剂可能通过改善心脏的收缩和舒张功能、改善心脏重构、降低心脏前后负荷、改善心肌能量代谢、调控神经-体液调节以及控制心血管危险因素等方式直接发挥心血管保护作用。此外,心力衰竭患者通常合并肾功能不全,SGLT2抑制剂可改善肾功能发挥间接心血管保护作用。本文对目前报道的SGLT2抑制剂改善心力衰竭可能的多效作用机制进行总结。

Sodium-glucose cotransport protein 2(SGLT2)inhibitors are a class of drugs that are orally taken to lower blood sugar levels.Clinical studies have confirmed that SGLT2 inhibitors can improve the prognosis of patients with heart failure,regardless of whether they have type 2 diabetes.However,the mechanism is not clear,SGLT2 inhibitors may play a direct cardioprotective role by improving cardiac systolic and diastolic function,improving cardiac remodeling,reducing cardiac preload and afterload,improving myocardial energy metabolism,regulating neurohumoral modulation and controlling cardiovascular risk factors,etc.In addition,heart failure patients are often combined with renal insufficiency,and SGLT2 inhibitors can improve renal function to play an indirect cardiovascular protective role.This paper summarizes the possible mechanisms of SGLT2 inhibitors that have been reported so far and could improve heart failure.