钠-葡萄糖共转运蛋白-2抑制剂联合胰高血糖素样肽-1受体激动剂治疗射血分数保留的心力衰竭的探讨

Sodium-glucose cotransporter-2 inhibitor combined with glucagcn-like peptide-1 receptor agonist in the treatment of heart failure with preserved ejection fraction

射血分数保留的心力衰竭(HFpEF)是一个日益严重的公共卫生问题,约占心力衰竭(心衰)总数的50%,然而其病理生理机制尚未完全阐明。研究表明,心外膜脂肪组织(EAT)有望成为HFpEF早期防治的靶点,而钠-葡萄糖共转运蛋白-2(SGLT-2)抑制剂、胰高血糖素样肽-1(GLP-1)受体激动剂均可减少EAT。SGLT-2抑制剂已经被国内外心衰指南推荐用于HFpEF的治疗,但GLP-1受体激动剂仍证据不足,探讨二者联合治疗HFpEF的疗效及作用机制,可为临床防治HFpEF提供新的思路和治疗靶点。

Heart failure with preserved ejection fraction(HFpEF)is an increasingly serious public health problem,accounting for about 50%of the total number of heart failure.However,its pathophysiological mechanism has not been fully clarified.Studies have shown that epicardial adipose tissue(EAT)is expected to become the target of early prevention and treatment of HFpEF.while Sodium-glucose cotransporter-2(SGLT-2)inhibitors and glucagcn-like peptide-1(GLP-1)receptor agonists can reduce EAT.SGLT-2 inhibitors have been recommended for the treatment of HFpEF by heart failure guidelines at home and abroad,but the evidence of GLP-1 receptor agonists is still insufficient.To explore the efficacy and mechanism of the combination of these two agents in the treatment of HFpEF can provide new insights and treatment targets for clinical prevention and treatment of HFpEF.