Vascular and metabolic effects of SGLT2i and GLP-1 in heart failure patients

• Published in: Heart failure reviews Vol. 28; no. 3; pp. 733 - 744
• Main Authors: Correale, Michele, Lamacchia, Olga, Ciccarelli, Michele, Dattilo, Giuseppe, Tricarico, Lucia, Brunetti, Natale Daniele
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2023; Springer Nature B.V
• Subjects: Amino acids; Cardiology; Cardiovascular Diseases; Cardiovascular System; Congestive heart failure; Cyclic GMP; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Glucagon; Glucagon-Like Peptide 1; Glucose transporter; Heart Failure; Humans; Inflammation; Medicine; Medicine & Public Health; Metabolism; Mitochondria; Myocardium; Nitric oxide; Protein turnover; Sodium-Glucose Transporter 2 Inhibitors - pharmacology; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Heart failure; GLP-1 RA; Endothelial function; SGLT2i; Metabolic effect; Gliflozin
• ISSN: 1573-7322; 1382-4147; 1573-7322
• DOI: 10.1007/s10741-021-10157-y

Alterations of endothelial function, inflammatory activation, and nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway are involved in the pathophysiology of heart failure. Metabolic alterations have been studied in the myocardium of heart failure (HF) patients; alterations in ketone body and amino acid/protein metabolism have been described in patients affected by HF, as well as mitochondrial dysfunction and other modified metabolic signaling. However, their possible contributions toward cardiac function impairment in HF patients are not completely known. Recently, sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) have emerged as a new class of drugs designed to treat patients with type 2 diabetes (T2D), but have also been shown to be protective against HF-related events and CV mortality. To date, the protective cardiovascular effects of these drugs in patients with and without T2D are not completely understood and several mechanisms have been proposed. In this review, we discuss on vascular and metabolic effects of SGLT2i and GLP-1 in HF patients.